1024 Application 2021-2022
We are excited you are interested in joining Team 1024 - the Kil-A-Bytes at McKenzie Center for Innovation and Technology. Please complete the information below to submit your application. If you have any questions or concerns, please contact Mr. Jeff Smith at jeffreysmith@msdlt.k12.in.us
Last Name *
First Name *
School *
Grade *
T-Shirt Size *
Cell Phone *
Email Address (gmail address that isn't school account) *
Parent's Name *
Parent's Email Address *
Optional Secondary Parent Email Address
Parent Phone Number *
Are you a returning member? *
Which meeting night(s) will you attend fall semester? *
Required
Do you participate in any other fall after school activities? (sports, band, job, etc) If so what activity?
Do you participate in any other spring after school activities? (sports, band, job, etc) If so what activity?
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