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2021 BOSS Program Application

All fields are required.

Name
Address
Emergency Contact

Please use the format of xxx-xxx-xxxx.

Parent / Guardian 1

Please use the format of xxx-xxx-xxxx.

Parent / Guardian 2

Please use the format of xxx-xxx-xxxx.

All sizes are Adult.

Due to COVID-19 we are not sure if we will be able to hold BOSS as in person. If we have to make BOSS 2021 a virtual program are you still interested in attending?
The following information is requested solely for affirmative action and statistical purposes. It will not affect admission, and provision of this information is completely voluntary. Indicate your predominant ethnic background.

Please check all that apply.

Educational Institute
High School Address

Please use the format of xxx-xxx-xxxx.

Please use the format of xxx-xxx-xxxx.

High School Guidance Counselor
Additional Information

Please do NOT send the $50.00 Registration fee along with your application. Only if you are accepted will you have to pay the registration fee, which is non-refundable.

How did you and your parent/guardians hear about us?
If you heard about the BOSS Program from a past participant...
If you heard about the BOSS Program from a teacher...
If you heard about the BOSS Program from a flyer...
If you heard about the BOSS Program from a website...
If you heard about the BOSS Program from another source...
Guardian Consent



Signature

Date