Young Men of Distinction Application

Student
Student Name*
Student Phone Number
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Where Are You From (City, State)*
What School Do You Currently Attend*
Current Grade Level*
Current GPA*
Hobbies
Why do I want to be apart of Young Men of Distinction?*
What do you plan to achieve in being part of Young Men of Distinction?*
Please Select a T-Shirt Size*
I, First Name* Last Name* , Hereby commit to being part of Young Men of Distinction. Once I sign this, I am committed to being apart of this great organization and to being a great asset to this group. I must also commit to be at every meeting, event, conference, and workshop held or attended by Young Men of Distinction. I must be improving my grades or keeping good grades and always keeping good behavior at all times.
Student Name (Signature):*

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Student 1
Student Name*
Student Phone Number
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Where Are You From (City, State)*
What School Do You Currently Attend*
Current Grade Level*
Current GPA*
Hobbies
Why do I want to be apart of Young Men of Distinction?*
What do you plan to achieve in being part of Young Men of Distinction?*
I, First Name* Last Name* , Hereby commit to being part of Young Men of Distinction. Once I sign this, I am committed to being apart of this great organization and to being a great asset to this group. I must also commit to be at every meeting, event, conference, and workshop held or attended by Young Men of Distinction. I must be improving my grades or keeping good grades and always keeping good behavior at all times.
Student Name (Signature):*

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Student 2
Student Name*
Student Phone Number
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Where Are You From (City, State)*
What School Do You Currently Attend*
Current Grade Level*
Current GPA*
Hobbies
Why do I want to be apart of Young Men of Distinction?*
What do you plan to achieve in being part of Young Men of Distinction?*
I, First Name* Last Name* , Hereby commit to being part of Young Men of Distinction. Once I sign this, I am committed to being apart of this great organization and to being a great asset to this group. I must also commit to be at every meeting, event, conference, and workshop held or attended by Young Men of Distinction. I must be improving my grades or keeping good grades and always keeping good behavior at all times.
Student Name (Signature):*

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Student 3
Student Name*
Student Phone Number
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Where Are You From (City, State)*
What School Do You Currently Attend*
Current Grade Level*
Current GPA*
Hobbies
Why do I want to be apart of Young Men of Distinction?*
What do you plan to achieve in being part of Young Men of Distinction?*
I, First Name* Last Name* , Hereby commit to being part of Young Men of Distinction. Once I sign this, I am committed to being apart of this great organization and to being a great asset to this group. I must also commit to be at every meeting, event, conference, and workshop held or attended by Young Men of Distinction. I must be improving my grades or keeping good grades and always keeping good behavior at all times.
Student Name (Signature):*

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Student 4
Student Name*
Student Phone Number
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Where Are You From (City, State)*
What School Do You Currently Attend*
Current Grade Level*
Current GPA*
Hobbies
Why do I want to be apart of Young Men of Distinction?*
What do you plan to achieve in being part of Young Men of Distinction?*
I, First Name* Last Name* , Hereby commit to being part of Young Men of Distinction. Once I sign this, I am committed to being apart of this great organization and to being a great asset to this group. I must also commit to be at every meeting, event, conference, and workshop held or attended by Young Men of Distinction. I must be improving my grades or keeping good grades and always keeping good behavior at all times.
Student Name (Signature):*

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Student 5
Student Name*
Student Phone Number
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Where Are You From (City, State)*
What School Do You Currently Attend*
Current Grade Level*
Current GPA*
Hobbies
Why do I want to be apart of Young Men of Distinction?*
What do you plan to achieve in being part of Young Men of Distinction?*
I, First Name* Last Name* , Hereby commit to being part of Young Men of Distinction. Once I sign this, I am committed to being apart of this great organization and to being a great asset to this group. I must also commit to be at every meeting, event, conference, and workshop held or attended by Young Men of Distinction. I must be improving my grades or keeping good grades and always keeping good behavior at all times.
Student Name (Signature):*

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I,First Name* Last Name*, Parent or Guardian Name), hereby commit to be apart of Young Men of Distinction as the Parent or Guardian of the students listed on this application. As a Parent or Guardian of the student(s), I must maintain good attendance for my student to attend every workshop, meeting, and conference.
Parent/Guardian Name (Signature):*

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Should be Empty:

Parent