Youth Tour Application Form

PARENTAL/GUARDIAN PERMISSION:

I/We hereby give permission to submit his/her name as a candidate for selection to participate in the electric cooperative youth tour, coordinated through Kansas Electric Cooperative, Inc., and if selected, give him/her permission to travel as required.

Date:

Parent Information:
Parent/Guardian Name:
Email Address:
Phone Number:

Child Information:
Date of Birth:
School Attended:
Years in School:

T-Shirt Size:

Men's:	XXLXLLMS
Women's:	XXLXLLMS

List activities you have participated in at your school and any special honors you have received, such as class officer, plays, music, athletics, etc.:
[ACTIVITY - YEARS - REMARKS/HONORS]

List community activities you have participated in, such as FFA, 4-H, church, volunteer work, etc.:
[ACTIVITY - YEARS - REMARKS/HONORS]

List any hobbies, talents, special interests, etc.:

What are your future plans?

Anything else you would like to tell us about yourself?