Good Neighbors Club Program
Before you start planning activities through your club to support Good Neighbors, we want to get to know you better! Please fill out all sections thoroughly and completely before submitting the application. After you successfully complete the application, the Program Coordinator will contact you to set up a video call meeting.
Student's Name *
First and last name
Address *
Street Address, City, State & Zip Code
E-mail *
Cell Phone Number *
Grade *
Required
Birthday (We want to know so we can send you a treat on your special day!) *
MM
/
DD
/
YYYY
High School *
Parent/Guardian Name *
Parent/Guardian E-mail *
Parent/Guardian Phone Number *
School Club Advisor Name (if applicable)
School Club Advisor E-mail (if applicable)
School Club Advisor Phone Number (if applicable) *Example : (877) 499-9898*
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