1. Hialeah Gardens Builders Club
New Membership Application
2011-2012
Section I: Contact Information
Name______________________________________________________________
Student I.D.#____________Grade:_____ Date of Birth: ___________________
Address:___________________ City/State:_________________Zip Code_______
Cell Phone #:_______________________________
Can you receive text messages? ___yes ___no
Home phone #:_____________________________
Email: ____________________________________
Schedule
Period Subject Teacher Room #
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2. Hialeah Gardens Builders Club
Section II: Questionnaire
Are you able to attend our weekly after school
meetings?
Yes_________ No_________
Are you willing to participate in the required fundraiser? Yes___ No____
Do you have a friend[s] that would like to join Builders Club? [Write first & last
name]
___________________________________________________________________
___________________________________________________________________
Section III: Builders Club Pledge
I pledge on my honor to uphold the objects of Builders Club. To better my school,
my community, my nation, and myself.To aid those in need while enhancing
leadership capabilities and to encourage the fellowship of all mankind.
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