5P Character Education Application

Character Education Club 2008

Please Complete this form as accurately as possible.
Important information is marked in red.

Member Registration

First Name

Last Name

Grade Level

Third
Fourth
Fifth

Homeroom Teacher

( last name only)

Birth Date

Example (mm/dd/yyyy) )

Pervious Member

Yes
No

Pervious Members Only

One Year in Character Education Club
Two Years in Character Education Club
None

Availability

Days Available

Monday Tuesday Wednesday Thursday Friday

Best Time for Meeting

Before School (7:30 a.m. to 8:15 a.m.)
After School (3:05 p.m. to 3:50 p.m.)
Either Time

Personal Interests

Committee Interest

Please select from one to three options from the dropdown menu below. To select more than one option, click your fist option, depress and hold the CTRL key, and continue making selections.

Essay

Please tell us about yourself and any prior experiences you have that would make you an ideal candidate for the Character Education Club (CDC). Please include any suggestions that would benefit the CEC.