Wilkinson County TSA Membership Application

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Section One: Demographic Information

Email *

Student Name *

Student Grade Level *

9th

10th

11th

12th

Student Mailing Address *

Student E-mail Address *

Student Cell Phone Contact Number *

I give consent to be added WilCo TSA Remind group to receive text reminders and updates of chapter information, due dates, events, etc. *

Yes

Student T-Shirt Size *

Parent/Guardian 1 Name *

Parent/Guardian 1 Mailing Address *

Parent/Guardian 1 E-mail Address *

Parent/Guardian 1 Cell Phone Number

I give permission to add my name to the WilCo TSA Remind group to receive information about upcoming events, meetings, and other materials. *

Yes

Parent/Guardian 2 Name

Parent/Guardian 2 Mailing Address

Parent/Guardian 2 E-mail Address

Parent/Guardian 2 Cell Phone Number *

I give permission to add my name to the WilCo TSA Remind group to receive information about upcoming events, meetings, and other materials.

Yes

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