Applicant information
Date of Birth
Date of Birth
Do you live on your own
Address
Address
Home
Home
Mobile
Mobile
Quickest form of contact
Parent/Guardian Info
*If 18 and over use this for emergency contact
Relationship
Name
Name
Address
Address
Mobile
Mobile
Home
Home
Business
Business
Quickest form of contact
Name
Name
Address
Address
Mobile
Mobile
Home
Home
Business
Business
Quickest form of contact
Education Info
Did you graduate high school?
Academic Counselor
Academic Counselor
Phone Number
Phone Number
Work Info
Include days and times.
Do you/your family have a home computer?
Where do you mostly use a computer?
How/Where do you access the internet?
Do you qualify for free or reduced lunch?
Are you a resident of either of the following?
Are you currently involved in any youth organization/programs?
Do you need any additional support? (learning disabilities, Physical limitations, struggles in social situations)
Use a proper letter format.
Thank you for completing this application. We will be sending a confirmation email shortly that will contain very important information regarding this class. Please read it carefully.