2008band Member Inform

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BAND MEMBER INFORMATION CARD 20 - 20 SCHOOL YEAR

STUDENT LAST NAME : BAUMAN

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______________________________________________________________________________________________

1) Student First Name:_______JUSTIN______________

DOB: _11___/_26___/__92__ Sex: M Grade: __10_____

Student Cell: _298-449__ Student Email:[email protected]_______________________________

List auxiliary position(s)/band section(s):____none_________________________________________________

Allergies: _______none________________________________________________________________________

Prescription Medications:___none______________________________________________________________

______________________________________________________________________________________________

2) Student First Name:_____________________

DOB: ____/____/____ Sex: M / F Grade: _______

Student Cell: _______________ Student E-mail: _________________________________________________

List auxiliary position(s)/band section(s):_______________________________________________________

Allergies: __________________________________________________________________________________

Prescription Medications: ____________________________________________________________________


Updated 3/2008
PAGE 2 ADDRESS INFORMATION
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Student Primary Information:

Parent Names:___MOLLY & CHARLIE_______________________________________ Print information in Band directory YES

Address:___6486 AUTUMN WOODS BLVD _______ Zip ___34109____________

Telephone: Home:__514-8783 Mom Cell:___272-5395 Mom Work:_____377-1210_______

Dad Cell:___687-8572__ Dad Work:______SAME

Mom E-mail: [email protected]___ Dad/Additional [email protected]__

Interests: Chaperone Home FB Games: Y/N Chaperone Away FB Games: Y/N Chaperone Parades/events: YES

Fundraising: Y/N Concession: YES Public Relations: Y/N


Other Interests:______________________________________________________________________________________________

Secondary Address Information:

Parent Names:____________________________________________

Address:____________________________________________________ Zip ___________________

Telephone: Home:__________________ Mom Cell:___________________ Mom Work:_________________________

Dad Cell:___________________ Dad Work:_________________________

Mom E-mail: _________________________________________ Dad/Additional E-mail_______________________________________

Interests: Chaperone Home FB Games: Y/N Chaperone Away FB Games: Y/N Chaperone Parades/events: Y/N

Fundraising: Y/N Concession: Y/N Public Relations: Y/N


Other Interests:______________________________________________________________________________________________

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