YES Program Application Form

Parent/ Guardian Name*

First NameLast Name

E-mail*

Date*

Date

Cell Phone Number:*

Area CodePhone Number

Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Childs Name*

First NameLast Name

Child's Birth Date:

MonthDayYear

Child Gender (Male/Female)

Child's School

School

Child Grade *

Grade

How many computers do you own in your home?

Do you have internet access in your home?

Where did you hear about us?

Not required but if your child has a business idea please describe it here

PROGRAM RULES FOR PARENTS

A. Parents Responsibilities -- All parents have the responsibility to:

1. Will drop off and pick up students to and from class on time
2. Report problems to the appropriate staff

3. Show respect to other parents, students, instructors and all other staff

4. Inform instructors and / or staff with as much advance notice as possible when their children will not be able to attend class.

PROGRAM RULES FOR STUDENTS

B. Student Responsibilities -- All students have the responsibility to:

Contribute to maintaining a safe and orderly class environment that is conducive to learning
Report problems to the appropriate staff
Show respect to other persons and to property
Be familiar with and follow the rules of this Program
Attend every class unless, they are legally excused
Be in class on time and prepared to learn
Work to the best of their ability in all academic and extracurricular pursuits and strive toward their highest level of achievement possible
React to direction given by teachers, administrators and other personnel in a respectful, positive and cooperative manner
Ask questions when they do not understand the rules
Seek help in solving problems
Work to develop appropriate ways to manage anger
Accept responsibility for their actions
Dress appropriately for our program and program functions

....*

I have read, understood, and accepted the rules for membership.

Once you submit your application, we will contact you shortly to complete your membership application.

Thank you!

The Young Entrepreneurs Succeed (YES) Program Application Form