MUNCY PHOTOGRAPHY
CLASS OF 2012 SENIOR REP APPLICATION
APPLICANT INFORMATION
Last Name
First
Date
Street
Address
Apartment
/Unit #
City
State
Home
Phone
E-mail Address
Cell
Phone
Parents E-mail
Address
Mother's
Name
Father's Name
Height
Weight
ZIP
Hair Color
Eye Color
EDUCATION
High School
GPA:
School Activities, Hobbies, or Interests:
JUNIOR FRIENDS
Please list three junior class friends (Does not have to be from your high school)
Name
Phone
Email Address
High School
Name
Phone
Email Address
High School
Name
Phone
Email Address
High School
(
)
(
)
(
)
JOB EXPERIENCE
Place
Dates
--
Place
Dates
--
Tell us why you would be a good candidate for our model program.
Would you like to see your images displayed at different locations around town?
DISCLAIMER AND SIGNATURE
I certify that I am class of 2012 and that my answers above are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview
may result in my release.
Signature
Date