BHS INTERACT CLUB APPLICATION FORM
2007-2008
Name: _______________________________________________________________
Address:  _______________________________________________________________
City/State/Zip Code:___________________________________________________________
Telephone:  __________________________(h) _____________________________(c)
Email:  _______________________________________________________________
T-Shirt Size:                         S                      M                     L                      XL                   Other:______
Areas of interest:

Have you been a member before?       YES                                                       NO
If yes, do you have any suggestions or comments about the club? _________________________ ____________________________________________________________________________________________________________________________________________________________
Give some infornmation about yourself: _____________________________________________ ____________________________________________________________________________________________________________________________________________________________
Are you interested in becoming a board member?                                  YES                 NO
What grade are you in?                                                 9th        10th      11th      12th
Where are you?                                                        1A class:                                teacher:
                                                                                2A class:                                  teacher:
I understand and accept the principles of Interact, sponsored by the Lowcountry Rotary Club, as expressed in its purpose and objectives, and agree to comply with and be bound by the “Standard Interact Club Constitution”, “Interact Statement of Policy”, and by the laws of the club, I agree to pay $25.00 to the club of Interact for an Interact T-shirt and the convention trip if I qualify by service hours in February 2008.
Signature: ______________________________________________________________
Date: __________________________
 I as the parent of __________________________ agree to and understand that if my child does not uphold  and agree to comply with and be bound by the “Standard Interact Club Constitution”, “Interact Statement of Policy”, and by the laws of the club that they will be considered for dismissal from the club.
Signature:_______________________________________________________________
Date: _______________________________