Back
Continue to the Next Page
Applicant Information
Name:
*
First Name
Last Name
Preferred Name:
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth
*
/
Month
/
Day
Year
Date
Age
*
Email Address
*
example@example.com
Cell Phone Number
*
-
Area Code
Phone Number
T-Shirt Size (Adult sizes):
*
Small
Medium
Large
XL
2XL
3XL
Back
Next
Education & Parent Contact
School Attendance and Extracurricular Activities Information
School/College Currently Attending:
*
Grade/Year (ex: College Freshman)
*
Major:
*
GPA:
*
Parent Name
*
Parent E-Mail Address
*
Back
Next
Experience & Week Selection
Briefly describe/summarize your horse experience - list all accomplishments & volunteer/work experience
*
Which week of Horse Camp will you be able to serve as an instructor assistant volunteer?
*
Week 1: Sunday, June 30 - Thursday, July 4
Week 2: Sunday, July 7 - Thursday, July 11
Both Weeks
Back
Next
Additional Questions
Please answer the following questions.
Briefly describe yourself.
*
Briefly list/describe a mentor or coach that has helped shape you into the horseman that you are today. What major lesson did this person teach you? How do you intend to pass this knowledge to our Horse Campers?
*
Back
Next
Signature
I hereby certify that the above information is correct. I also authorize the Georgia FFA-FCCLA Center to perform a criminal history check on me for the purpose of certifying that I have not been convicted of a crime.
*
Date of Application Submission:
*
MM/DD/YYYY
Submit Application
Should be Empty: