PLEASE COMPLETE BOTH SIDES! Last Name: ________________________ First Name: _______________________Class of: ’18 ’19 ’20 ’21 Phone Number: __________________________ E-mail address: ___________________________________

Membership Application Signature Page The application process requires you to fill out the online form (link available in the announcements section of the BHS Student Council Webpage) completely, complete this Membership Application Signature Page (available on the website or from campus Student Council Advisor), and pay student council membership dues ($30). This signature page includes an RSVP for the retreat, as well; it is preferred for all members to attend the retreat on September 1-2. If you participate and meet your point requirements, you will be a considered a Student Council Member. Membership will be revoked if standards are not maintained. Last Name: ____________________________ First Name: ______________________________  

I completed the online application. _____Yes _____No (Please note that completing the online application is mandatory for membership.) I am paying my dues, as indicated on the back of this page. _____Yes _____No (Please note that paying dues is mandatory for membership.)

As a member of Student Council you are expected to participate in a variety of activities. Some of the responsibilities are as follows: paying dues, making posters, bringing supplies (cookies, poster board, etc.), community service projects, dressing appropriately on theme days, and much more. You are expected to abide by the Student Council Constitution. The main idea of the constitution is that you will be a student above reproach and set an example of moral and ethical living for all. (If you would like a copy of the Constitution, see the website or the student council advisor.) All members are requested to serve on a planning committee (choices to be ranked on backside of paper) and must complete the minimum number of points on each month’s point sheet. If you agree to all statements above please sign below. Student Signature: _______________________________________ I agree to my student’s decision to become a part of the Boswell High School Student Council and support any disciplinary actions, including removal from membership, which may be taken during his/her involvement. Parent Signature: ________________________________________________________________ Teacher Recommendations (You must have three. WE WILL CONTACT THEM FOR RECOMMENDATION. YOU JUST NEED THEIR E-MAIL.)

Teacher Name

Subject

E-mail

1 2 3 PLEASE GO TO REVERSE SIDE OR SECOND PAGE.

PLEASE COMPLETE BOTH SIDES! Last Name: ________________________ First Name: _______________________Class of: ’18 ’19 ’20 ’21 Phone Number: __________________________ E-mail address: ___________________________________ This form should be completed and returned to Ms. Keyes in person (BHS Room G123 or A104) or Mrs. Newcomb (A121) or via mail (BHS Student Council 5805 W. Bailey Boswell, Fort Worth, Texas, 76179, Attn: Katie Keyes) no later than Wednesday, August 30, 2017.

Student Council Payment I am including a total of $__________ to cover:  _____dues only ($30)  _____additional scholarship donation (_____) I understand that failure to pay the dues or making arrangements to do so revokes my student council membership. _____Yes or _____No

TO BE COMPLETED UPON RECEIPT OF FUNDS BY STUCO OFFICIAL: Payment Type:

Check

or

Cash

Amount Received: _____________________ Check Number: _______________________ Receipt Given By: _____________________

Member Signature __________________________ Parent Signature ____________________________ Member Name (Printed)______________________Parent Name (Printed)_________________

All checks should be written to Boswell High School Student Council and should have student name and ID number in the memo section. Cash is also accepted. You may return to Ms. Keyes or Mrs. Newcomb at the very beginning of school, or mail to: Boswell High School Student Council 5805 W. Bailey Boswell, Fort Worth, Texas, 76179, Attn: Katie Keyes.

Student Council Retreat RSVP Will you be attending the retreat?

_____ Yes or _____ No

Do you have a parent who can help sponsor the retreat? If so, include phone number. ________________________________________________________________________

Completion of application process verifies admittance into the council. Please log on to the Boswell High School Student Council Website (goo.gl/eRYWAI) to get more information about the retreat and summer workdays. Dues payments should be received no later than the retreat.