Become a member of the Quaker Bridge Mall Teen Board!!! We are searching for new candidates for this year long program of community service, fashion, public relations and theatrical merchandising. Applicants should be young men and women, between the ages of thirteen and eighteen, who are well rounded, outgoing, and have an interest in fashion, dance, theater, retail, public relations/marketing, and community service.
BEFORE BEGINNING TO FILL OUT THE FORM, BE SURE YOU CAN READ THE SECURITY CODE AT THE BOTTOM OF THE PAGE. IF NOT, REFRESH THE PAGE BEFORE FILLING OUT THE FORM!
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| PERSONAL INFORMATION: |
| Full Name: |
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| Address: |
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| city: |
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| State: |
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| Zip Code: |
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| Home Phone: |
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| Cell Phone: |
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| Email Address: |
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| AIM: |
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| Age: |
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| Date of Birth: |
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| SCHOOL & WORK: |
| Current School Attending: |
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| Current Grade: |
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| In the Fall of 2010 will you be at the same school: |
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| If no, where do you plan to attend?: |
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| Do you work part-time or full time?: |
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| If yes, where?: |
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| What is your work schedule?: |
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| TEEN BOARD AWARENESS: |
| Do you know anyone on teen board?: |
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| If yes, who?: |
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| Have you attended a teen board fashion show?: |
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CLOTHING SIZES:
The following information is required but is not considered as a factor in the overall review of your application. Should you be accepted as a Teen Board member, this information is critical for the production of fashion oriented events. |
| Height: |
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| Weight: |
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| Hair Color: |
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| Dress Size: |
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| Pant Size: |
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| Shirt Size: |
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| Shoe Size: |
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| Men: Jacket Size: |
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| Men: Waist: |
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| Men:Inseam: |
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| Provide a link to a photo of you - http://:: |
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| ACTIVITIES & APPLICATION QUESTIONS: |
| List current (the past two years only) school activities: |
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| List current (the past two years only) non-school activities: |
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| List Dance, Acting or Modeling experience you have had in the past 3 years: |
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| Why do you want to join the Quaker Bridge Mall Teen Board?: |
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PARENTAL PERMISSION:
I hereby give my consent for my son/daughter as named on this application to apply for the Quaker Bridge Mall Teen Board for the year 2010 and should he/she be accepted in to the program, I further give my consent for his/her participation.
In addition, I agree to undertake to indemnify and hold harmless The Quaker Bridge Merchants, Kravco Simon Company, Rainbow Promotions Inc. and its agents, servants and employees from and against any and all claims, damages, actions, liability and/or expenses in connection with damage to personal property, personal injury and/or loss of life arising from or out of the event/activities associated with participation in the Quaker Bridge Mall Teen Board.
Should my son/daughter be selected as a member of the Quaker Bridge Mall Teen Board for the year 2010, I hereby give my consent to The Quaker Bridge Merchants, Kravco Simon Company, Rainbow Promotions Inc. and its representatives, employees and agents, to take, use and reproduce photographs, negative or positive, of my son/daughter as named on this application for editorial, publicity, promotion, advertising, on-line and non-commercial purposes. I further agree that NO compensation will be provided for such use and that all negatives and/or positives, will remain the property of The Quaker Bridge Merchants, Kravco Simon Company, Rainbow Promotions Inc.
AGREED BY DIGITAL SIGNATURE: (If accepted, a physical signature by a parent will also be required.) |
| Parent/Guardian Full Name: |
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| Date: |
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