EmailMe Form - 2018/19 Erik's Junior Apprentice Program

Name *

First Last

Email *

Phone *

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

Date of Birth xx/xx/xxxx *

Name of School *

Emergency Contact *

First Last

Emergency Contact Phone *

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

Store Location *

Please Choose The Closet Erik's Location Within 10 Miles Of You

Have you participated in the Erik's Junior Apprentice Program in the past? *

Yes (Please elaborate below)

No

Please elaborate if you answered yes above.

Do you have prior Bicycle Mechanic knowledge? (Please note this has no bearing on your acceptance to the program)

Yes

No

Do you participate (if available) in a NICA program? (Please note this has no bearing on your acceptance to the program)

Yes

No

Why are you interested in the Erik's Junior Apprentice Program? (Essay) *

What would you like to gain from this program that will help you succeed scholastically, personally and professionally? *

Have you shopped at an Erik's Bike-Board-Ski retail location before? (Please note this has no bearing on your acceptance to the program)

Yes

No

Comments, Questions, Concerns?