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Freedom Academy Online Application Form

Please consider me for attendance at the 2010
Michigan Freedom Academy, 11-16 July, 2010.

Name:

(as you would like it to appear on certificates, awards, etc)

What you would like to be called (nickname):

Address:

City:

State:

Zip:

Phone:

E-mail:

Gender:

T-Shirt Size (Adult men's size)

Cumulative grade point average

Must mail or fax transcript or report card showing cumulative GPA*

I am a high school sophomore or junior and will graduate
in June of JROTC

High School:

High School Counselor:

Counselor Phone:

Where did you hear about the Michigan Freedom Acadamy?

High school counselor
ROTC/JROTC
VFW referral
FA Liaison Officer

I am a returning delegate**
A friend
Legislative referral
Other (tell us below)

Referring VFW Post, National Guard Member,
Liaison Officer, referring delegate, or other(if applicable):

* Verification of GPA: Mail or fax a copy of a recent transcript or report card showing cumulative GPA to the Michigan Freedom Academy, 3411 N. Martin Luther King Jr. Blvd., Lansing, MI 48906 or fax 517-481-8125.

**To be accepted as a returning delegate,
you must still meet the GPA requirement.
You will also have to refer a qualified individual
to the camp. Your acceptance is contingent upon your sponsored applicants acceptance.


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