FLL TEAM MEMBER APPLICATION PERSONAL INFORMATION Student Name Parent/Guardian Name Street Address Email Address Telephone Number Gender Male
Birth Date Grade
Female
EXPERIENCE Have you previously participated in an Jr FLL or FLL competition? Yes
No
If you answered Yes, please describe your participation, including any duties you performed:
SKILL CLOUD
DEADLINE: Your application and essay MUST BE received by Friday, March 12, 2011. Please mail orlemail this completed application to: Sean Lewis, Coach or E-mail to: eaglesnestrobotics@gmail.com Eaglesnest Academy Robotic Club For questions please Phone: 304-551-8399 4 Blakeney Rose Lane Hunntington, WV 25705