Graduation Recognition Form

Graduation Recognition Form

Please only complete this form if you are a member of The Brook and will be graduating from middle school or higher AND you would like to participate in the June 11th Graduate Recognition during the 10:30am service.
Today's Date

MonthDayYear
Type of Degree/Certificate Received:*
Graduate's Name*

First NameLast Name
Graduate's E-mail*
example@example.com
Graduate's Phone Number*
Please enter a valid phone number.
Parent's Name*

First NameLast Name
Parent's Email*
example@example.com
Parent's Phone Number*
T-Shirt (Adult Size)*
Middle School/High School/ College/Graduate School Attended:*
Please list name of the Middle School, High School or College you are graduating from.
Date of Graduation:*

MonthDayYear
Date
Program of Study:
For college graduates only.
Please list any accomplishments or honors you are graduating with.
What's Next?
College/University:
For high school graduates only, list name of technical school/college/university that you will be attending.
Military:
For high school graduates only, if you plan to enlist in military, which branch?
By uploading and submitting a photo below, I, the graduate or I the parent or legal guardian of the named child, hereby grant The Brook permission to use the photo in The Brook's publications, videos, or other digital media, including web-based publications (website, social media outlets etc.).
Please upload picture of graduate. (Preferably senior pictures or cap and gown pictures.)

Cancelof
Should be Empty: