KEMPA SJW Camp Registration 2018
Last Name *
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First Name *
Your answer
Email *
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Home Address *
Your answer
Student Cell Phone Number *
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Twitter Handle
Your answer
Birthdate *
Your answer
Grade in Fall *
Your answer
Sex *
T-Shirt Size *
Parent/Guardian's Name *
Your answer
Parent/Guardian's Cell Phone Number *
Your answer
SCHOOL INFORMATION
School Name *
Your answer
School Phone Number *
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School Address *
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ADVISER INFORMATION
Adviser's Name *
Your answer
Adviser's E-Mail *
Summer e-mail is preferred
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Adviser Phone Number *
Your answer
MEDIA STAFF INFO
Media Name *
Newspaper/Magazine/Yearbook/Broadcast/Website Title
Your answer
Staff *
Select all that apply.
Required
Are you a KEMPA member publication? *
Is your media a class or a extracurricular? *
List the journalism classes and/or camps you've participated in previously. If you haven't attended another camp or had a journalism class prior, please write "none." *
Your answer
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