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Class of 2010: Senior Rep App

This is my survey.

Your Name

First
Last

Today's Date

Select date

Facebook Profile (Direct Link)

High School You Attend

High School Graduation Date

Tell me about yourself! (Personality, style, what you like to do, etc.)

Are you involved in extracurricular activities?

Yes
No

What are they?

Why would you be a good rep for Visive?

Anything else I should know that would make me choose YOU as a senior rep?

Email Address

Phone Number

Cell is best, area code first.

Address

Street
Street Address Line 2
City
State
Zip Code

Do your parents have any opposition to your being a senior rep?

Yes
No