10-8 SQUAD Educational Program Application Form
10-8 SQUAD Version
*
Spanish
English
Student Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Fecha Nacimiento
School level:
*
Elementary School (3rd to 5th Grade)
Middle School (6th to 8th Grade)
High School (9th to 12th Grade)
School Name and Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student email address (optional):
example@example.com
Student phone number (optional):
Parent or Legal Guardian Full Name
*
First Name
Last Name
Parent phone number:
*
Parent Email Address
*
example@example.com
Physical address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mailing Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
If your child is selected to participate in the 10-8 SQAUD, as pre-requisite, parents and participants are required to take the 10-8 SQUAD Orientation. Do you accept?
*
Yes
No
Signature of Parent or Guardian
Submit
Should be Empty: