Application for Junior Gym Leader

1^st Semester Grade from Sophomore P.E. _______________________

1^st Semester Sophomore P.E. Teacher __________________________

2^nd Semester Sophomore P.E. Teacher__________________________

School Activities, Athletics, Clubs and Honor Achievements

Hobbies, Interests and Activities Outside of School

Experience/Training in Leadership Roles

Write a statement as to why you would like to become a leader and what you think the program will do for you.

Any physical restrictions in P.E. (Explain)

Are you planning on Early Graduation? _____________________

If chosen as a gym leader, I will be a member of the gym leader class my entire junior and senior year unless I am removed. I will not opt out of P.E. for athletics.

Signed (Student)_____________________________

Signed (Parent)______________________________

Dated _____________________________________

Please return this completed form to your Physical Education Instructor

By January 15, 2010