Contact Information Request
Please help Western keep in touch!
First Name
*
Last Name
*
Birthdate
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Month
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Day
Year
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Student Cell Phone (if available)
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Area Code
Phone Number
Student email address (if available)
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field. Please add appropriate
blank
fields and text.
Name of Your 8th Grade Advisor
Math Class you will take next year as a freshman
*
Pre-Algebra
Algebra 1
Geometry
Algebra 2
Not sure or undecided as yet
Please select the sports you played at Western, if any:
Football
Basketball
Baseball
Soccer
Rugby
Track
Wrestling
Cross Country
Did you participate in music or shows at WA?
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Please Select
Yes
No
Select all that apply
Choir
Band
Guitar
Shows - Cast
Shows - Stage or Tech Crew
Did you ever win a class Bard Competition while at WA?
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Please Select
Yes
No
Which year, what poem?
Clubs or Activities: Math Club, Yearbook, Rocketry, etc.
Recognition - Awards or Scholarships:
General remarks about your years at Western:
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