41st Senior Salute Student Registration Form
Congratulations on your nomination to attend the 40th Annual Senior Salute Luncheon on Saturday, April 25, 2020 at the Kellogg Hotel and Conference Center.

Instructions: The following information will be used for two purposes: (1) to send you and your family a formal invitation to the luncheon, and (2) to create a profile of you in the Senior Salute Souvenir Book that will be distributed at the luncheon. Please make sure that you complete this form by FRIDAY, FEBRUARY 28, 2020.
Your High School *
If you selected "Other" above for your high school, then please tell us the name of your high school below.
Your answer
Your Cumulative High School GPA *
Your answer
Your Name (First Name, Middle Initial, Last Name) *
Your answer
Your Street Address, City, State, and Zip *
Your answer
Your Phone *
Provide the best number to reach you.
Your answer
Your Email Address *
Your answer
Parent/Guardian Name(s) *
Provide first and last names.
Your answer
Parent/Guardian Address (If different from above) *
If this address is the same as yours, put N/A.
Your answer
Parent/Guardian Phone (If different from above) *
If this number is the same as yours, put N/A.
Your answer
List a maximum of three (3) school clubs, sports, music, dance and other extra-curricular activities that you have been involved in. Please include the year(s) of involvement (for example, Member of the Theater Club, 2018-2020). *
Your answer
List a maximum of three (3) church and community activities that you have been involved in. Please include the year(s) for the activities (for example, Volunteer with the Mobile Food Pantry, 2019). *
Your answer
List a maximum of three (3) leadership positions/offices held, awards, accomplishments, and special recognitions received. Please include the year(s) (for example, Vice President of the Black Student Union, 2019-2020). *
Your answer
What are your future education and career goals after graduating high school? List college or vocational school that you will attend, your major, and career plans. If you will pursue a military career, please list that and the branch you plan to serve. *
Your answer
Senior Salute Luncheon Attendance *
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