АНКЕТА ДЛЯ ЧЛЕНІВ БУЛАВИ - 2019
на пластовий лещетарський табір для юнацтва Gore Mountain, North Creek, NY
Я є: *
Are you a Male or Female?
Required
пл. ступінь *
Must be registered and have dues paid.
прізвище *
Last name in Ukrainian
ім’я *
First name in Ukrainian
Last Name *
Last name in English
First Name *
First name in English
e-mail *
Please enter an e-mail you will check most frequently
e-mail confirmation *
Буть ласка ще раз записати бо може бути помилка. Please confirm your e-mail.
Cell Phone number *
Area code and number - Numbers only, no dashes or parenthesis please.
Home phone number *
Area code and number - Numbers only, no dashes or parenthesis please.
Address *
House number/ apt # and Street Name
City *
State or Province *
Zip Code / Postal Code *
Дата народження (Birth date) *
Minimum age = 18, maximum age = 200. (MM/DD/YYYY) Please type in the correct YEAR...Current year is the "default" and if you were actually born in the current year then you shouldn't be applying. Thanks!! :)
MM
/
DD
/
YYYY
Рік народження (CONFIRM Birth year) *
Please enter your birth YEAR... just in case you made a mistake. Thanks!! :)
Де ти ходиш до школи? або де ти працюєш?
University Name? or where do you work?
Студії або професія
What are you studying? Or what is your occupation?
Курінь *
Are you a member or candidate of a Plast Kyrin? If so, which one?
станиця *
What Stanytsia do you belong to?
Untitled Title
Розмір сорочки: *
t-shirt size
ТАБОРОВИЙ ДОСВІД - Подати останних 5 таборів від найновішого
Please list the last 5 camps you attended. Where? Year? what kind of Camp? your role in the camp?
ВИХОВНА ПРАЦЯ В СТАНИЦІ
Please provide the years and which Улади (УПН; УПЮ) you worked with.
ПЛАСТОВІ ЛЕЩЕТАРСЬКІ ТАБОРИ
Відбув(ла) лещетарський табір в? Years you attended ski camp and your function.
РІВЕНЬ ЇЗДИ НА ЛЕЩЕТАХ
What is your sking ability?
Clear selection
РІВЕНЬ ЇЗДИ НА Дошці?
Snowboarding ability?
Clear selection
ПОЗИЧЕННЯ ВИРЯДУ *
Equipment rentals. Please remember that HELMETS are a requirement for all.
Required
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy