Distinguished Service Graduate
Application Form
For all Freshman Academy Students and New Students
Student ID _____________
Year in School __________
Name _____________________________________________________
Address ____________________________________________________
City ______________ Zip _____________ Phone _________________
Email Address ______________________________________________
* Are you a member of Key Club?
Y
N
I have read and agreed to the requirements.
_________________
_____________________
Student Signature
Parent Signature
Distinguished Service Graduate
Application Form
For all Freshman Academy Students and New Students
Student ID _____________
Year in School __________
Name _____________________________________________________
Address ____________________________________________________
City ______________ Zip _____________ Phone _________________
Email Address ______________________________________________
* Are you a member of Key Club?
Y
N
I have read and agreed to the requirements.
_________________
Student Signature
_____________________
Parent Signature