Created: May 25 2013

Student Council information form

Name:_____________________
Homeroom:_________________
Home Phone #:(___)-___-_____
Cell Phone #:(___)-___-_____
Address:___________________________________________________________
__________________________________________________________________
______________________________________
Birthday:_________________________
Age:______________________
Classes: Please include teacher name and course code. If any information changes alert Sam
Jacobs or Sydney Norris ASAP, failure could result in the loss of signing privileges.
Semester 1:

Semester 2:

Period
1:____________________

Period
1:____________________

Period
2:____________________

Period
2:____________________

Period
3:____________________

Period
3:____________________

Period
4:____________________

Period
4:____________________

Attendance:
Just a reminder that if you are absent from a meeting and have a excuse, please contact
the secretary (NAME) or the communication heads (Sam Jacobs, Sydney Norris).
3 unexcused absences will result in dismissal at the presidents discretion. 2 unexcused lates
count as one unexcused absence. For more information contact the communication heads.

Office use only:

Inputted: ______

Constitution:_______
By:____________________