* Full  Name:
             
* Email:
* Current
Address:
* Phone#:   (Where I can be reached now)
  Cell Phone#: 
  Contact Time:    (Best to time to contact you)
  Martial Status:                    
  Spouse's Name:
  Children:
  Occupation:
  Employer :
  Address:
  Telephone:        Contact Person: 
  Position Desired:
             Drama/Arts
             
  What are your main areas of interest:
  Smoking Status:            
  Availability: I am available for all Camp Dates        
(June 16,2017 until August 13, 2017)
    If NO, specify:
    How did you hear about Wah-Nee?
  Comments:
   
    
     

 

 
 
 

Days: Hours: Mins: Secs: