Student Information
FCY Youth Students
Name
First Name
Last Name
Student Phone Number
-
Area Code
Phone Number
When is your birthday?
-
Month
-
Day
Year
Date
What school do you go to? (ex: Gainesville HS, Home School)
What grade are you in?
6th grade
7th grade
8th grade
Freshman
Sophomore
Junior
Senior
Do you play sports or any extracurricular activities? (Choir, JROTC, Boy/Girl Scouts)
Parent Phone Number
-
Area Code
Phone Number
Parent Email
example@example.com
Student Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Submit
Should be Empty: