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Student Information - 2018 FRC Team
Information is confidential, and will only be used by the Team's Head Mentors and School Liaison for team-related business and communications.
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* Indicates required question
Student First Name
*
Your answer
Student Last Name
*
Your answer
GBHS Student ID Number
*
Your answer
Birthday
*
MM
/
DD
/
YYYY
Graduation Year
*
Choose
2018
2019
2020
2021
Student E-Mail Address
*
Your answer
Student Cell Phone Number (XXX) XXX-XXXX
*
Your answer
Student Home Phone Number (XXX) XXX-XXXX
*
Your answer
Text Messages
*
Do you receive Text Messages as part of your cell phone plan?
Yes
No
I don't have a cell phone
Student Primary Residence is with:
*
Mom and Dad
Mom
Dad
Mom and Step-Dad
Dad and Step-Mom
Other:
Student Primary Address:
*
Your answer
Student has been officially diagnosed with the following Learning and/or Behavioral Disabilities/Disorders:
*
Please select all that apply
ADD
ADHD
Autism Spectrum Disorder or Asperger's
None
Other:
Required
Student Allergies or Special Food Needs:
*
Your answer
Additional Information
Please list any additional information that you think would be important for Clinton and Brandi to know:
Your answer
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