Student Registration Roster

Please print or type name clearly

School Name: _____________________________ School Representative: ______________________

School’s Council District: __________ Contact # for Day of Event: ___________________

School Questionnaire

School Name: ______________________________________________________________________________

School Rep: _______________________________________________________________________________

Are any student organizations represented in your group? If so, which ones?

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

How were students selected to participate? __________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

Please fax this form to at 210-918-5628

If you have any further questions regarding how to fill out this form

call 210-918-2215 or 210-207-1338

Thank you and we look forward to seeing you there!

Office Use Only: Date Received: ___/___/___ Form Entered: ___/___/___

#Student NameGrade#Student

NameGrade1262273284295306317328339341035113612371338143915401641174218431944204521462247234824492550