2022-2023 Membership Application

2022-2023 HoPe Membership Application
Student Full Name*

First NameLast Name
Student E-mail*
Student Phone Number*
What is your preferred method of contact?*

Phone CallTextEmailNo preference
Home Address*

Street Address

Street Address Line 2

CityState

Zip Code
Student Birth Date*

MonthDayYear
What is your race?*

Indigenous American or Alaskan NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhite
Are you Hispanic, Latino, or Latinx?*

YesNo
Country of Origin*
What is your family's country (countries) of origin?
Gender*
SCHOOL INFORMATION
Do you have a HoPe Chapter at your high school?*

YesNo
What high school do you attend?*
If "other," please list the high school you attend?
What is your grade for the 2022-2023 school year?*
What is you high school student ID?*
What is your Instagram Handle?
We would love to connect on IG! :)
MEMBERSHIP

The following questions refer to your choice of membership:
- Regular Paid Membership: Access to all programming, t-shirt, and access to HoPe Cord.
- Free Membership: Access to all programming.
If you have a HoPe Chapter at your school, you will pay your membership dues directly to your school.

If you do not have a HoPe Chapter at your school, you will pay your membership dues (if applicable) at the end of this application.
What membership are you interested in?*

Regular Paid Membership - $25Free Membership - $0
T-shirt Size*
EDUCATIONAL

The following questions will help us provide you educational content and support.
Are you a First Generation college student? *
Will you (or your siblings) be the first in your family to attend college in the US?
Do you qualify for Free/Reduced Lunch?*
Where you ever a part of an English As A Second Learner program? (ESL/ESOL?EL)*
Do you currently have any education-related questions or concerns?
PARENT/LEGAL GUARDIAN INFORMATION
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Email *
example@example.com or N/A
Parent/Guardian Number*
By signing below, you confirm you filled out this form in its entirety, and the information you provided is accurate to the best of your knowledge.
Student Signature:*
Typed name serves as your signature..
Parent/Guardian Signature:*
Typed name serves as your signature..
Thank you for submitting your HoPe Membership Application!

HoPe!

Breathe it! Live it! Love it!
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2022-2023 HoPe Membership Application