BOSS (Cleveland) Application
Please complete the entire form
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Email *
First Name: *
Last Name: *
Email *
Mobile Phone *
Home Phone
Street Address *
State *
Zip Code *
School *
Grade *
Date of birth *
Hobbies and Interests (List 3) *
Do you play sports for Muny, school, church or travel? *
Are you willing to make your academic and personal success as much a priority as your athletic success? *
How did you hear about our program? *
Person to contact in case of emergency
First Name *
Last Name *
Relationship *
Phone number *
References: email letter to after completion of application.
Please provide a letter of reference from a school administrator, teacher, coach or counselor who can attest to your character and commitment to developing “whole”, positioned and prepared to live a life of purpose.
Participation Agreement
By submitting this application, I affirm that the facts set forth in my application for participating are true and complete. Thank you for completing this application form and for your interest in participating in our Boss program. All the information recorded above is considered confidential.
Parent name/consent (if under 18):
First Name *
Last Name *
Date *
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