Name:________________________________________________________________________

Address:______________________________________________________________________

City, State, Zip:________________________________________________________________

Phone:__________________________Email:___________________________________________

Name of school you are presently attending:__________________________________________

Birth date:_________Birthplace:______________________________Sex:__________________

Name of AFA Regular Member you are employed by:_________________________________

Name of parent(s) employed by AFA Regular Member:__________________________________

Parent(s) listed above is employed by:_______________________________________________

Postsecondary school(s) you have applied to:_________________________________________

____________________________________________________________________________

______________________________________________________________________________

Return completed application portfolio by April 3, 2000 to (applications must be received prior to or on April 3 to be considered):