JrFLL TEAM MEMBER APPLICATION (JR FLL Applicants may need assistance to fill this out by a parent) PERSONAL INFORMATION Student Name Parent/Guardian Name Street Address Email Address Telephone Number Gender Male
Birth Date Grade
Female
EXPERIENCE Have you previously participated on a JrFLL Team?
Yes
No
If you answered Yes, please describe your participation, including any duties you performed:
SKILL CLOUD
If you would like, please attach a small information excerpt about yourself. The Application Deadline is April 15th. Please email or FAX this completed application to: Laurie Lewis Coach and Mentor Eaglesnest Robotics E-mail to: eaglesnestrobotics@gmail.com For questions please email us or call us Phone: 304-972-1577