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Hialeah Gardens Builders Club
                             New Membership Application
                                    2011-2012

      Section I: Contact Information

      Name______________________________________________________________
      Student I.D.#____________Grade:_____ Date of Birth: ___________________
      Address:___________________ City/State:_________________Zip Code_______
      Cell Phone #:_______________________________
      Can you receive text messages? ___yes ___no
      Home phone #:_____________________________
       Email: ____________________________________


                                        Schedule
    Period                  Subject                      Teacher                Room #




1
Hialeah Gardens Builders Club

    Section II: Questionnaire


    Are you able to attend our weekly after school
    meetings?
    Yes_________ No_________

    Are you willing to participate in the required fundraiser? Yes___ No____

    Do you have a friend[s] that would like to join Builders Club? [Write first & last
    name]
    ___________________________________________________________________
    ___________________________________________________________________

    Section III: Builders Club Pledge

    I pledge on my honor to uphold the objects of Builders Club. To better my school,
    my community, my nation, and myself.To aid those in need while enhancing
    leadership capabilities and to encourage the fellowship of all mankind.




2

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Application

  • 1. Hialeah Gardens Builders Club New Membership Application 2011-2012 Section I: Contact Information Name______________________________________________________________ Student I.D.#____________Grade:_____ Date of Birth: ___________________ Address:___________________ City/State:_________________Zip Code_______ Cell Phone #:_______________________________ Can you receive text messages? ___yes ___no Home phone #:_____________________________ Email: ____________________________________ Schedule Period Subject Teacher Room # 1
  • 2. Hialeah Gardens Builders Club Section II: Questionnaire Are you able to attend our weekly after school meetings? Yes_________ No_________ Are you willing to participate in the required fundraiser? Yes___ No____ Do you have a friend[s] that would like to join Builders Club? [Write first & last name] ___________________________________________________________________ ___________________________________________________________________ Section III: Builders Club Pledge I pledge on my honor to uphold the objects of Builders Club. To better my school, my community, my nation, and myself.To aid those in need while enhancing leadership capabilities and to encourage the fellowship of all mankind. 2