2020 Holland CHAOS Student Application
Please complete this form if you are a Holland High School or Black River Public Schools student interested in being on the 2019-2020 Holland FIRST Robotics team.
First Name *
Last Name *
Email Address *
Cell Phone Number *
Birthday *
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/
DD
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Age *
Class Next Fall *
i.e. if you are a junior now, you will be a senior in the fall of 2016
First and Last name of Parent/Guardian *
Parent/Guardian cellphone number *
Parent/Guardian email address *
2nd Parent/Guardian First and Last name
2nd Parent/Guardian cell phone
2nd Parent/Guardian email address
Food Allergies/ Health Issues *
School Attending *
Current Cumulative G.P.A.
On a scale of 1 - 10, how important is it for you to earn (or to have earned) a varsity letter? *
Not important
Very important
On a scale of 1 - 10, how interested are you in becoming an engineer? *
Not interested
Very interested
On a scale of 1 - 10, how interested are you in pursuing a STEM degree? *
Not interested
Very interested
Please select any subjects that you would like to learn and work on: *
Don't be afraid to check something you know nothing about. We will train you, if you have the interest!
Required
Please select your top 2 culture interests *
Required
Are you a returning team member, or is this your first year? *
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