Adult Skills for Baker Teens
 Basic Life Skills preparedness for 11th and 12th graders

 Registration Form

Name: _______________________________

School: ________________________________ Gender: ______

Grade: ______________ Age: ________________

Phone #: ___________  Email: ________________________

Address: ____________________________________________________

Parent/Guardian Name: _____________________________________

Hobbies: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please fill out and email form back to
Cynthia Grimes: CGrimes@cityofbakerla.com