Teens 2 Work Registration

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To enroll in the Teens 2 Work Program, please fill out the following form.

YOU MUST HAVE AN ACTIVE BOYS & GIRLS CLUB REGISTRATION TO BE A PART OF THIS PROGRAM.

Register using the link below

BGCTRIC Registration

or Contact Eydie at the Boys & Girls Club at 920-361-2717 for more information

Email *

Todays Date *

YYYY

Student's First & Last Name *

Student's Number *

Student's Email (We connect mainly through email so it is VERY important that you provide an email you will check daily) *

Parent/Guardian Name (s) *

Parent/Guardian Name Phone & Email *

Emergency Contact Name & Phone *

Please list any known Allergies or special instructions *

Have you registered with The Club? *

Yes

Not sure

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