Peterstown TEC Wheat Team Application
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number
-
Area Code
Phone Number
Cell Phone Number
-
Area Code
Phone Number
Age
*
Email
*
example@example.com
Year in School, if applicable
Name of School, if applicable
What TEC team(s) were you on?
*
Which weekend(s) would you be interested in?
*
October
November
February
March
Why do you want to be on a Wheat team?
*
If you have questions, call or text Brenda at (815) 973-6606 or email bbarnickel6@gmail.com
Submit
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