Application Form

Application for Participation

Please provide the following information:

Parent/Guardian
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Telephone Number
E-mail

Applicant's First name
Applicant's Last name
Applicant's Middle initial	(Optional)

Age
Date of Birth	Month / Day / Year
GPA

School Name
School Street
School City
School State
School Zip

How did you hear about Preteen?
HONORS AND ACTIVITIES
Academics and Honors	Volunteer Service	Arts	Athletics
Honor Roll Student	Fund Raising	Dance	Cheerleading/Gymnastics
Student of the Week/Month	Animal Aide	Music	Basketball
Science Fair Participant	Disaster Relief	Drawing/Painting	Softball/Baseball
Academic Award Winner	Charitable Donations	Writing	Soccer
Spelling Bee Participant	Religious Activities	Crafts/Sewing	Skating
Perfect Attendance	Hospital/Nursing Home	Language Arts	Track&Field
School Clubs	Neighbor/Family Assistance	Cooking	Tennis/Golf
Other	Other	Other	Other

You will be notified by mail within 10 days from our receipt of your application as to your acceptance status