Lessons for Life Member Application 23

Lessons for Life Member Application
Thank you for your interest in Lessons for Life. Below are the fees associated with the Lessons for Life programs.

FREE spots are available!

Nothing Was The Same - $125
VIEWS ft. The Campus - $175
Both Programs - 10% discount

These fees allows us to further our mission of being dedicated to fostering the lives of middle and high school students through financial literacy, occupation opportunities, life skills, and workforce ettiquete.

If finances are an issue for you, we offer a sliding scale payment approach to help you join us. Please call us at 804-592-6556 for more information to see if you qualify.

Applicant Requirements:
- 2.5 GPA minimum
- At least a rising 6th to 12th grader
Please complete the application in full. Incomplete applications will not be reviewed.
How did you hear about Lessons for Life?

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Congratulations *
Program Selection
Number of Participants*
Select the program that your student will participate in: *Select all that apply**

Nothing Was The Same - $125VIEWS ft. The Campus - $175Both - 10% discount
Student Information

Student 1
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Name of Middle or High School Attending*
Current Grade*
GPA at the end of the last academic school year*
Shirt Size*

Student 2
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Name of Middle or High School Attending*
Current Grade*
GPA at the end of the last academic school year*
Shirt Size*

Student 3
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Name of Middle or High School Attending*
Current Grade*
GPA at the end of the last academic school year*
Shirt Size*

Student 4
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Name of Middle or High School Attending*
Current Grade*
GPA at the end of the last academic school year*
Shirt Size*

Student 5
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Name of Middle or High School Attending*
Current Grade*
GPA at the end of the last academic school year*
Shirt Size*

Parent Information

Parent
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*

Confirmation Email
Preferred Contact Phone Number*

Area CodePhone Number

Payment
Do you qualify for the sliding scale?*

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