Joseph_Owens (Student Enrollment)

Student Enrollment Application

Information

First Name: Joseph
Last Name: Owens
Gender: Male
Birthdate: March 4th, 1995
Home Address: Ganton Housing Projects
Cellphone Number: 916916
Guardian/Parent's Name(s) if Applicable: Shaquifa Jackson
Guardian/Parent's Job(s) if Applicable: N/A
Guardian Telephone Number if Applicable: 1564403
Guardian/Parent Email if Applicable: SJackson@Gmail.com

Student Signature:   ____________________________________________________________________________________________

Medical Information

Major Medical Conditions:
Minor Medical Conditions:
Any conditions that will need an inhalant or a pill during school: No __________________________________________________________________________________________

(( Out of Character ))

First Name: Jimmy
Age: 16
Geographical Location & Timezone:Pacific Time

Agreement

I agree to take responsibility to any roleplay, good or bad, that I do in Los Santos High School. I also agree to roleplay realistically and the best I can, and take responsibility for any brawl-provoking or any trolling, etc. I agree to accept any punishment for a rule I have broken, and to take my punishment fully. I agree to be admin kicked, admin jailed, or even banned by an administrator if necessary.

Signature: Jimmy