FALL 2018 JRNOLA PROGRAM APPLICATION
Application form for participants for the Fall 2018 Program (beginning in September 2018)
Date of Birth
Prefer not to say
Other (please explain)
What grade level will you be entering in the Fall of 2018?
School Attending in the Fall of 2018
Faculty or School Sponsor: Name
Faculty or School Sponsor: Phone
Faculty or School Sponsor: Email
Please upload a recommendation letter from the student's faculty sponsor. This can also be emailed to
if you don't have it at this time.
Do you have any allergies? We may have snacks periodically, and need to know if anything is off-limits.
The program runs from 5 PM to 7:30 PM in the evening. Which days of the week are you available at that time?
How will you get to the program?
Parent/Guardian drive you
RTA Bus system
Do you have access to a computer and the internet when not at the center?
Yes - I could work on my stories at home if need be.
No - I need to be at the center to research and write my stories.
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