2021-22 Interact Membership Form
WHAT IS INTERACT? It's all about GIVING BACK/COMMUNITY SERVICE!
See the website for more information: https://nwrnehs.wixsite.com/nwrinteract 

Please complete this form with the requested information (drug forms, club dues, etc.).  
Club dues - $15 membership fee.
CLUB DUES WILL NOT BE COLLECTED UNTIL OCTOBER 13. DO NOT TRY TO TURN THIS IN TO ANYONE RIGHT NOW. These will be turned in to Mrs. Cockrell (D119) - Checks made out to NWRHS.

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Email *
I understand that club dues are required for membership, but I cannot turn the money into Mrs. Cockrell (D119) until she returns to school October 13. *
Required
First Name *
Last Name *
Grade as of 2021-22 *
T-Shirt Size *
Would you like to be an Interact Club Officer? If yes, choose one:
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If you would like to be an officer, please provide 2 teacher references here.
What do you believe about the Interact Motto: Service Above Self? *
Why do you wish to become a member of the Interact Club?  (Include any contributions that you can make towards the success and goals for the club.) *
What are some activities that you have done in the past that has helped those in need? *
If you were a member last year, what were some activities that you would like to continue?
I understand that if I miss THREE meetings (excused or unexcused), I will be dismissed from the club. *
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