| Applicant Information | |||||
|---|---|---|---|---|---|
| Name | Cameron Spitz | ||||
| Address | 1512 S 22nd St Sheboygan, Wisconsin 53081 Map It | ||||
| Phone | (920) 334-1771 | ||||
| Email hidden; Javascript is required. | |||||
| Date of Birth | 08/21/2008 | ||||
| Gender | Male | ||||
| Marital Status | Single | ||||
| Current Status | Attending High School | ||||
| High School | |||||
| High School Grade | Senior | ||||
| Name of High School | Sheboygan South High School | ||||
| High School Address | 1240 Washington Avenue Sheboygan, Wisconsin 53081 Map It | ||||
| College/University Information | |||||
| Business/Trade School | |||||
| Future School | |||||
| If you are not currently attending a College/University, Trade or Business School provide the information below of the future school. |
| ||||
| General Information | |||||
| Do you plan on working while attending college? | Part Time | ||||
| Sponsor's Name | Shirley Spitz | ||||
| Sponsor's membership status | EANGUS Auxiliary Life Member | ||||
| Signature of Applicant | //SIGNED//CAMERON SPITZ | ||||
| Required documents upload here |
