High School Volunteer Enrollment Form

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High School Application

Personal Information

*First Name:

Middle Initial:

*Last Name:

Date of Birth:

Age: Gender:

Home Address: City:

State: County: Postal Code:

Email Address: *Home Phone #:

Mobile Phone #: Work Phone #:

Social Security #:(xxx-xx-xxxx) Ethnicity:

Do you have a Driver's License? If Yes, state of issue:

Driver's License #: Expiration date of driver's license:

Has it ever been revoked or suspended?

If yes, provide date and reason:

How many years have you lived in this county?

High School: Grade: Teacher Name (reference):

Do you anticipate any changes in your residence in the next year?

If yes, please explain:

Have you given the parent reference and permission form to your parent(s)/guardian:

If so, what did they have to say about it?