Kids4K9s - BALTIMORE HUMANE SOCIETY

Kids 4 K9s

Teen Summer Program at the Baltimore Humane Society
Please complete the following application. Each of the narrative questions must have a response.
DEMOGRAPHICS
African-AmericanAsianCaucasianHispanicNative AmericanOther
Name of high school you are attending
Applicant Information
Applicant's first and last name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:
Please enter the best number to reach you.Format: (000) 000-0000.
Phone Number
Alternate phoneFormat: (000) 000-0000.
PARENT / GUARDIAN / EMERGENCY CONTACT
Name

First NameLast Name
Relationship?
Phone Number
Please enter the best number to reach you.Format: (000) 000-0000.
Phone Number
Alternate contact phoneFormat: (000) 000-0000.
Email
example@example.com
ELEMENT OF INTEREST
Please tell us why you are interested in participating in the summer program at the Baltimore Humane Society?
TRAINING-RELATED EXPERIENCE
YesNo

Kids 4 K9s