FUTURE BUSINESS LEADERS OF AMERICA

StudentApplication
PLEASE PRINT
Student ID Number:
I First Name: I Last Name:
*Gender: Male Female I
*Grade: 9 10 11 12
*T-Shirt Size: S M L XL XXL
Address:
Home Phone Number:
Cell Phone Number:
E-mail Address:
Mother's Name: Work Phone #:
Father's Name: Work Phone #:
*Circle only one option in each category

SCHEDULE:
. . -. . -"-'" .:~

. Period
5 6 7 None (Circle One)
5 6 7 None (Circle One)
(Circle One)

I, , promise
A. to attend at least 6 of the monthly FBLAmeetings in a school year,
B. to participate in one major community service/volunteer project each semester,
C. to participate in one fundraiser each semester,
D. to attend one of the district and/or area leadership conferences/competitions,
E. to workactivelyas a committeememberand/orchairman,
F. to adhere to all FBLA standards, rules, and regulations during functions.

STUDENT'S SIGNATURE

FBLA Membership fee--$25.00

FBLA Shirt--$10.00

Return this form (completed) along with a check for $25.00 (or $35.00 if purchasing shirt) made payable to
THS for membership dues (or membership dues and shirt).

All checks must have driver's license number for identification.

It is the policy of Katy ISD not to discriminate on the basis of sex, disability, race, religion, color, or national origin in its
educational programs and/or activities nor in its employment.practices.
My signature on this document constitutes permission for my son/daughter to be
photographed or videotaped during FBLA related activities. These pictures may
be used in the newspaper, training exercises, school web page, publicity, program
promotion, or club memory book.

PARENT SIGNATURE DATE

STUDENT SIGNATURE DATE

It is the policy of Katy ISD not to discriminate on the basis of sex, disability, race, religion, color, or national origin in its
educational programs and/or activities nor in its employment.practices.