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Houston FFA Membership Information Sheet
Please complete the following information to be put into the FFA roster.
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Last Name
*
Your answer
First Name
*
Your answer
Middle Initial
Your answer
Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
Gender
Your answer
Grade
*
Choose
9th
10th
11th
12th
Graduation Year
*
What year will you graduate?
Choose
2016
2017
2018
2019
Ethnicity
Hispanic, Non-hispanic, non-disclosed
Choose
Hispanic
Non-hispanic
Non-disclosed
Race
Choose
White
Hispanic/Latino of any race
American Indian or Alaskan Native
Black or African American
Asian
Native Hawaiian or other Pacific Islander
Two or more races
Non-disclosed
Residential Type
What best describes where you live?
Choose
Rural/Farm
Rural/Non-farm
Small Town
Urban/Suburban
T-shirt Size
*
Choose
Small
Medium
Large
XL
XXL
XXXL
Father's Name
Your answer
Father's Occupation
Your answer
Father's Phone Number
Your answer
Father's Email Address
Your answer
Mother's Name
Your answer
Mother's Occupation
Your answer
Mother's Phone Number
Your answer
Mother's Email
Your answer
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