DanversCARES Youth Leadership Form Sign-Up
ALL High School and Middle School students interested in being a DanversCARES Youth Leader MUST fill out this form by September 29, 2017.
Student's First Name *
Your answer
Student's Last Name *
Your answer
Grade *
Please indicate your current 2017-18 school year grade level.
Your Danvers Public Schools student gmail address.
Your answer
Your cell phone number for meeting reminders. *
Your answer
Street Address *
Your answer
City
Your answer
State
Your answer
ZipCode
Your answer
Home Phone Number *
Your answer
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Parent Email Address
Your answer
Additional Parent Email
Your answer
Do you have any medical concerns we should know about for safety reasons during out of school time, such as: you carry an epi pen for allergic reactions, you use an inhaler for asthma, etc.
If you answered yes, please indicate your medical concerns.
Your answer
What is your preferred T Shirt Size?
What best describes your gender identity?
What is your race?
Are you Hispanic/Latino?
Please select your age range:
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