STUDENT APPLICATION – Future Fridays

Personal Information:

Name___________________________________________________________ Gender  Male

First Middle Last  Female

Address ______________________________________________________________________________
Street City State ZIP

Home phone ___________________________ E-mail address _________________________________

Father/Guardian’s name _________________________________________________________________

Work phone ___________________________ Occupation ____________________________________

Mother/Guardian’s name ________________________________________________________________

Work phone ___________________________ Occupation ____________________________________

Emergency contact ______________________ Home phone __________________________________

Work phone ____________________________ Relationship ___________________________________

School Information:

1. Name of school ___________________________________ Grade level _________GPA___________

2. List the classes you are taking this year:

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

3. What are your favorite subjects?

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

3. What subjects do you feel you need help with?

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Your Interests:

1. What are your hobbies and interests?

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

2. Do you participate in any extracurricular activities outside of school (e.g., Boy/Girl Scouts, youth
programs)? If yes, explain:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

3. What is your career goal or what types of careers interest you?

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

4. Do you plan on attending college after you graduate?  Yes  No

5. What would you like to learn more about or become better at with the help of our staff?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Favorites:

What is your favorite...

Food _______________________________________________________________________________
Color _______________________________________________________________________________
Book _______________________________________________________________________________
Movie ______________________________________________________________________________
Music Group _________________________________________________________________________
Song _______________________________________________________________________________
Person ______________________________________________________________________________

What three words best describe you? ______________________________________________________

 STUDENT/PARENT CONTRACT

I, ___________________________________, agree to allow to participate in Solid

Foundation’s - Future Friday . I understand that the organization wants to help me to be a
success in school and in life and will act as a friend, advisor, and role model. I also understand
that no monetary assistance is provided by the program.

In return, I agree to:

• Try hard to have a good relationship with all Foundation staff members;

• Notify facilitator if I cannot keep an appointment for any reason;

• Respect the guidelines set by the program;

• Abide by the rules and regulations of the program;

• Communicate with the program coordinator if I feel uncomfortable or experience

problems at any time during the program; and

• Fill out a survey at the end of the workshop.

_________________________________ ________________________________
Parent/Guardian Signature Student Signature

_________________________________
Date
 PHOTO RELEASE FORM

Solid Foundation or various other media may choose to take pictures or videotape
participants in Solid Foundation activities. These images may be used for Solid Foundation
displays, brochures, newsletters, archives, news releases, publicity and Web sites.

I hereby grant permission to Solid Foundation to take and reproduce photographs and
videotapes for publication, including publication by news sources and other sources for all
educational, trade, advertising and other purposes as determined by
Solid Foundation .

______________________________ __________________________ ________

Print Name

Signature
Date

______________________________ __________________________ ________

Printed Parent/Guardian Name Parent/Guardian Signature (if minor) Date

Address: _______________________________________________________________

City, State, ZIP Code: _____________________________________________________