2023-2024 Membership Application

2023-2024 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 2023-2024 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:
- Paid Membership: Access to all programming, membership t-shirt, access to exclusive HoPe Scholarships, and access to Graduation Cord for elegible seniors.
- Free Membership: Access to all programming.
Please pay your membership dues to your local HoPe Chapter. If you have any questions on how to pay, please contact your Chapter Advisor or Legacy Leaders.
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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2023-2024 HoPe Membership Application