4488 Club Registration 2018-19 - DUE 10/10
Welcome to the Club Season for the FRC Team 4488 Shockwave! This form must be filled out by the student applying to be part of the team.
Email address *
Student Name (FIRST + LAST) *
Birth Date *
Grade *
Gender *
Race (Racial and Ethnic Categories and Definitions - https://grants.nih.gov/grants/guide/notice-files/not-od-15-089.html) *
Ethnicity (needed for grants) *
Home Address and City *
Student Cell Phone (xxx-xxx-xxxx) *
Home Phone Number (xxx-xxx-xxxx)
Student Email Address - GMAIL *
MUST use a Gmail to join the club. This email may be different from the one Google Drive is collecting above.
Mother/guardian Name *
Mother/guardian Email *
Mother/guardian cell number *
Father/guardian Name *
Father/guardian Email *
Father/guardian cell number *
What's the best way to contact your parents/guardians in case of an emergency? *
Add work phone number if best contact number
If applies
T-shirt size (men/adult size) *
Jacket size (adult size) *
How many years have you been a member of Team Shockwave? *
What other extra-curricular activities are you involved with this fall? *
What other extra-curricular activities are you involved with this winter? *
In what groups would you like to participate? All students should participate in at least on one tech and one non tech groups (nt). *
Please select all areas you want to learn - most require no experience, unless noted.
From the list above, please list the two you like the best (in order of preference): *
What relevant classes have you taken at Glencoe or PCC? *
What is the main reason you're interested in joining our Club? *
Please note, this answer will be considered in your Team Application in December.
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