Returning Member Application
Member Name: *
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Nickname (optional):
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Address: *
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Apt. #:
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City: *
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State: *
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Zip: *
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Home Phone:
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Cell Phone:
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Gender: *
School: *
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Grade: *
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D.O.B: *
Format: _____/_____/_____
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Culture: *
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Email: *
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Parent 1 (Custodial) Name: *
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Relationship: *
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Home Phone (if different):
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Cell Phone:
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Parent 2 Name:
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Relationship:
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Home Phone (if different):
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Cell Phone:
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T-Shirt Size: *
Sweatshirt Size: *
Essay Questions
Minimum of five sentences per question
What skills did you gain as a 2014-2015 member of Urban Underground? *
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Give an example of an experience you had as a 2014-2015 member and what you learned from it. *
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How has what you learned as a 2015-2015 member benefited you at home, in school and in your community? *
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What skills and or experiences do you hope to gain as a 2015-2016 member? *
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How can we support you to ensure you're successful as a 2015-2015 member? *
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