GRKL Student Information Form

Kappa Alpha Psi Guide Right Kappa League - St. Petersburg, FL Chapter

Student First Name

Middle Initial

Last Name

Upload Photo of Student

Address

City

State

Zip

Date of Birth

Age

Number of Siblings

Student Email

Student Phone Number

Interests, Talents, Hobbies?

Name of Current School

Grade

Current GPA

HS Graduation Year?

What career are you interested in after high school?

What College, Trade school or other Institution would you like to attend after high school?

Father/Guardian First Name

Last Name

Phone Number

Mother/Guardian Name

Last Name

Phone Number

Emergency Contact Person

Phone Number

Relationship to you?

I would like to be contacted about being a volunteer in the Guide Right Kappa League Program

Yes No

Privacy and Consent Statement

Agree

Yes No

Volunteer Today