Courtesy Corps Application
Personal Information
Name
*
First Name
Last Name
School
*
Division
*
Middle School
High School
College/Postsecondary
Participant Type
*
Student
Advisor
Parent
Administration
Other
Gender
*
Female
Male
Non-Binary
Other
Date of Birth
*
-
Month
-
Day
Year
T-Shirt Size
*
Please Select
X-small
Small
Medium
Large
X-Large
XX-Large
XXX-Large
Personal phone number
*
Please enter a valid phone number.
Email - gmail, hotmail, yahoo, etc.
*
example@example.com
Current (Overall) Grade Point Average
*
Trade Program Area:
*
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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School Information
School Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School Phone
*
Please enter a valid phone number.
SkillsUSA Advisor Name
*
First Name
Last Name
SkillsUSA Advisor Email
*
example@example.com
SkillsUSA Advisor Phone
*
Please enter a valid phone number.
Principal/Director Name
*
First Name
Last Name
Principal/Director Phone number
*
Please enter a valid phone number.
Principal/Director Email
*
example@example.com
Chapter SkillsUSA Advisor
*
First Name
Last Name
Advisor's Telephone Number
*
Please enter a valid phone number.
Advisor's Email
*
example@example.com
Program Level
*
Secondary
Post-Secondary
Advisor
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Emergency Contest/Personal Information
Emergency Contact Name - 1
First Name
Last Name
Emergency Contact Phone - 1
Please enter a valid phone number.
Emergency Contact Email - 1
example@example.com
Emergency Contact Relationship - 1
Emergency Contact Name - 2
First Name
Last Name
Emergency Contact Phone - 2
Please enter a valid phone number.
Emergency Contact Email - 2
example@example.com
Emergency Contact Relationship - 2
Please list any medications prescribed, including dosage.
Parents must provide permission for students to keep medications on their persons. Permission forms will be sent following acceptance.
Please list any physical restrictions, disabilities, or other information that would be beneficial for our team to know.
Insurance Information
Include insurance company, policy number, group number, and primary policy holder name
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Application Questions
How would you benefit from being part of Courtesy Corps?
*
How would you improve the Courtesy Corps team?
*
Have you ever worked in a volunteer situation before? If so, please share your experience.
*
What leadership skills do you possess?
*
What does it mean to "act ethically"?
*
What does it mean to be a servant leader? How does Courtesy Corps engage in servant leadership?
*
Code of Conduct and Signatures
Upload signature documents here.
*
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Consent
*
I have read, understand and agree to the above National Courtesy Corps Code of Conduct and Requirements. I will apply myself for the purpose of learning and uphold the highest standards to represent SkillsUSA, SkillsUSA Florida and the State and National Courtesy Corps.
Full Legal Name
*
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