INITIAL SIGN UP APPLICATION
1) Name __________________________________________________________ 2) Age and Birthday __________________
3) Sex M or F
4) Student Contact Info
Address _______________________________________________________________________________________
Phone _____________________________ Email _____________________________
5) Parent/Guardian Info
Name __________________________________________________________ Relation _______________________
Addresses (if different than student's)
_______________________________________________________________________________________
Phone _____________________________ Email _____________________________
Name __________________________________________________________ Relation _______________________
Addresses (if different than student's)
_______________________________________________________________________________________
Phone _____________________________ Email _____________________________
6.) A quick description of the intended experience or youth program.
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
7.) One teacher signature/recommendation
Print __________________________________________________________
Sign __________________________________________________________
Class Taught ____________________________________________________
Teacher Comments (optional)
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
DO NOT FORGET!! The following are also needed with this form for initial sign up:
Click here to download The Patched Overalls Application.