DFSC Junior Board

Membership Application - 2010-2011

Name: _________________________________

Age: _____________________ Birthday: ______________________

Grade for 2010 – 2011: _____________________

Mailing address: _____________________________________

_____________________________________

_____________________________________

Phone Number: _____________________________________

E-Mail: _____________________________________

Facebook name: _____________________________________

Skating Level: _______________________________

Rink(s) you skate at: ____________________________________________________

Prior Junior Board Experience: ____________________________________________________

____________________________________________________

Prior Volunteer Experience: ____________________________________________________

____________________________________________________

Will you commit to attendance at JB Meetings and Volunteer Service hours? ________________

What strengths and/or skills do you have that would be an asset to the Junior Board?

What ideas do you have that you feel would be of benefit to the Junior Board?

Your Signature: ____________________________ Parent Signature: _____________________

Mail completed form to: Cathy Grygar, 125 North Forest Lane, Double Oak, Texas 75077
Form must be postmarked by August 1, 2010.