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Student Liaison Application

2. Name
4. Address
6. City
7. State
8. Zip Code
10. Phone Number
11. Email Address
13. Gender
    -- Select One --MaleFemale
14. Grade Level this Fall
16. What clubs and/or sports are you currently involved in?
18. Why You Want to Join the Board
    Write a paragraph explaining why you want to be on the North Huntingdon Township Recreation Board.
20. Teacher Signatures
22. #1 Teacher
23. #2 Teacher
25. #3 Teacher
26. #4 Teacher
28. Instructions
    Please send the completed application, signed Student Liaison Job Description.
    North Huntingdon Director of Parks and Recreation
    11279 Center Highway
    North Huntingdon, PA 15642
30. Student Liaison Job Description
    Student Liaison Job Description (PDF)
32. Signature*

    I have read and understood the expectations set forth by the North Huntingdon Township Recreation Board.

    1. I Agree
34. Student Liaison Name
35. Date
    Date
37. North Huntingdon Recreation Board, President
38. Date
    Date
Leave This Blank:


39. Print Only

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