EmailMe Form - STUDENT MEMBER OF THE BOARD APPLICATION

Name *

First Last

Student ID# *

Approximate Current Unweighted GPA *

Address *

Street Address City State / Province / Region Postal / Zip Code

Phone *

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

Email *

Teacher Reference *

Please list who you will be giving your reference form to - they will need to complete the recommendation and return it to the WCHS Ed Foundation mailbox in the Main Office by April 13, 2015.

Extracurricular Activities, Both In and Out of School *

Essay *

In an essay of 500 words or less, please discuss your thoughts on how the Educational Foundation can support the Churchill community. Include what you can contribute as a student member of the Board.