EmailMe Form - Class of 2018 EMP Senior Model Application

Name *

First Last

Nickname *

Phone *

### - ### - ####

Email *

What High School do you attend? & Graduation year *

Parent/Guardian Name *

Parent/Guardian E-mail *

Parent/Guardian Phone *

### - ### - ####

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Instagram User Name *

Do You Have a job? *

Yes

No

If yes, where? What Hours do you work?

What clubs, organizations, activites are you involved in? *

What are your hobbies and interests? *

Where do you like to shop? *

3 words that describe you. *

Why would you make a good senior rep for EMP? *

If selected to come in for a student/parent meeting we will have a short 30-45 minute meeting. (please select your 1st, 2nd, and 3rd choices for your student/parent meeting)

First Choice
Second Choice
Third Choice

Please upload 2 photos of yourself. (1MB max size, please) *

*

IF YOU ARE SELECTED....As a senior model, your senior session is FREE!!!! You also receive a HUGE discount on any prints your purchase. By initialing this box, you understand that there is a $350 fee to be an EMP Senior Model. This will cover your senior session and other expenses while you are an EMP Senior. *

Parent/Guardian Electronic Signature. Signature will be verified. *