Pre-Enrollment Application

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Character Development Program Application

Student Information

Team Member Name:

First

Last

Date

Date of Birth

(mm/dd/yyyy)

Age

Race

Shirt Size

Bottoms Size:

Guardian Information

Parent/Guardian Name:

First

Last

Address:

City

State/Province

Zip/Postal

Country

Date of Birth:

Email address:

Cell #:

Phone #:

Emergency #:

Number of Residents in household (including yourself):

Religious Preference:

List all organizations, extracurricular, clubs your son/daughter is involved in:

Describe your son’s or daughter’s conduct behavior at school, home and/or other:

Describe any pronounced challenges that your son/daughter may be having (social, moral, and physical)?

To your knowledge, has your son/daughter been involved in the abuse of any substance (himself, family, friends)?

To your knowledge is your son/daughter involved in any gang activity (him/herself, family, friend)?

Character Development Intake Questions

To be completed by student

What happens at the end of a school day?

What responsibilities (chores) do you have?

What do you like to do with your free time?

What was the happiest time in your entire life?

What was your proudest moment?

What was your saddest moment?

Rank your relationship with your mother (1-10) 10 being the highest:

Rank your relationship with your father (1-10) 10 being the highest:

What are some things you would hope to improve with your mother or father?

What tools do you use to settle down when you are angry?

Have you ever tasted alcohol? If yes, what was it like when you first tasted alcohol?

Have you ever used marijuana? If yes, what was it like when you first used marijuana?

Have you had your first kiss? If yes, what was it like for you?

How far do you think a girl should go with a boy when dating?

What are your academic goals?

What kind of student are you? What kind of student are you capable of being?

What is your greatest weakness?

What is your greatest strength?

How do you see yourself in 5 years from now?

Who is your favorite artist?

What is your favorite kind of music?

What are your favorite hobbies?

What is the most important quality a woman should have?

If you are human, leave this field blank.

"If you’re walking down the right path and you’re willing to keep walking, eventually you’ll make progress."

- Former President, Barack Obama