MEMBERSHIP APPLICATION

Name:_____________________________________________

Address:___________________________________________

___________________________________________________

Phone:_____________________________________________

E-mail:_____________________________________________

Current GPA:______________ or HS GPA:_______________

I am currently enrolled in _____________ units.

Major:_____________________________________________

Are you interested in serving as an officer?_______________

Interests/hobbies:____________________________________

___________________________________________________

___________________________________________________

List any special skills:________________________________

___________________________________________________

___________________________________________________

Computer access?____________________________________

Times Available:_____________________________________

Social Security No:_______-_____-_________

X__________________________________________________

Student's Signature (is required to access Gavilan College Academic Records)

Please return application to Hope Jukl - PH 113