Name:
Name:
Cell/House Number:
Cell/House Number:
Email:
Email:
Facebook: (Add me! “Mark Rayos”)
Facebook: (Add me! “Mark Rayos”)
Birthday:
Birthday:
Any charity /event ideas?
Any charity /event ideas?
Circle those that apply-
Circle those that apply-
Preferred Method(s) of Contact:
Preferred Method(s) of Contact:
TEXT CALLING
FACEBOOK EMAIL
TEXT CALLING
FACEBOOK EMAIL
Grade: 9 10 11 12
Grade: 9 10 11 12
New Member: Yes No
New Member: Yes No
Membership Status:
Membership Status:
YES I am joining Key Club and will pay dues
YES I am joining Key Club and will pay dues
I’m not sure yet…
I’m not sure yet…
I plan on buying a Divisional Ninja T-shirt ($12):
I plan on buying a Divisional Ninja T-shirt ($12):
Yes! T-shirt size S M L XL
Yes! T-shirt size S M L XL
No
No
I plan on attending AIDS Walk LA, October 17th
I plan on attending AIDS Walk LA, October 17th
Yes
Yes
No
No
I plan on attending Fall Rally, Six Flags
I plan on attending Fall Rally, Six Flags
November, 20th (Around $25-$35)
November, 20th (Around $25-$35)
Yes
Yes
No
No
Signature X________________________________ Signature X_______________________________
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