Senior Rep Application
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Name *
First  MI  Last
Address *
Street
City, ST ZIP
Phone *
Email *
Direct link to your Facebook profile (having a Facebook page is required) *
High School
Parent/Guardian Name *
Parent/Guardian Phone *
Parent/Guardian Email *
What extracurricular activities do you participate in through school or another youth organization? (Sports, Church, Leadership, Scouts, etc) *
Do you feel like you are a good influence on your peers? (describe) *
What is your most embarrasing moments (this is a great icebreaker)? *
How often are you on facebook? *
Why should I pick you as a Senior Rep? *
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