Our Minds Matter Application Form
Email address *
Club Essentials:
Name of School *
Your answer
Best Shipping Address *
Your answer
How did you hear about us? *
Name of Club Sponsor *
Your answer
Email of Club Sponsor *
Your answer
Contact phone number *
Your answer
Club Sponsor is... *
It's recommended that at least one of your club sponsors is a school psychologist, social worker, or counselor!
Required
Additional Club Sponsor
Your answer
Email of Club Sponsor
Your answer
Club Sponsor is... *
It's recommended that at least one of your club sponsors is a school psychologist, social worker, or counselor!
Required
How often does your club plan to meet? *
Your answer
Where do you plan to hold your meetings? *
Your answer
What name do you want to place before 'Minds Matter' as your official club name? (i.e. your school name or school mascot) *
Your answer
What are your school colors? *
Your answer
Student Leadership:
Name of Club President *
Your answer
Email of Club President *
Your answer
Phone number of Club President *
Your answer
Preferred method of contact
Name of Club Vice President *
Your answer
Email of Club Vice President *
Your answer
Phone number of Club Vice President *
Your answer
Preferred method of contact
Name of Club Treasurer *
Your answer
Email of Club Treasurer *
Your answer
Phone number of Club Treasurer *
Your answer
Preferred method of contact
Name of Club Secretary *
Your answer
Email of Club Secretary *
Your answer
Phone number of Club Secretary *
Your answer
Preferred method of contact
Name / Email of additional officers
Your answer
Other info. you want us to know
Your answer
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