Name
*
First Name
Last Name
Email Address
*
Phone
*
(###)
###
####
What is the best way to get in touch with you?
*
If other, please specify below.
What school do you currently attend?
*
Bassick
Bridge Academy
Bullard-Havens
Central
Fairchild Wheeler
Harding
Kolbe Cathedral
Other (Please list):
If other, please list.
What grade are you currently in?
*
9th
10th
11th
12th
1. Are you interested in participating in after-school, extracurricular, or summer activities?
*
2. Are you currently participating or have you recently participated in any after-school, extracurricular, or summer activities?
*
3. If you're not participating in any activities, why not? Please select all that apply.
*
If other, please explain.
4. Please select the types of activities below that you would be interested in participating in.
Sports/Physical
Art/Music
Miscellaneous
If other, please list.
5. Of the activities you selected above, please list the top 3 activities you'd like to participate in.
Comments:
