LOS  AMIGOS  MEMBERSHIP  APPLICATION  FORM  

Los  Amigos  Name:   Birthdate:  

School  in  Fall  2017:  

Grade  Entering  Fall  2017:   High  School  Graduation  Date:  

Parent Name(s):    

Address:  

Home  Phone:  

Los  Amigos  Cell  Phone:   Los  Amigos  Email:  

Mother’s  Cell  Phone:   Mother’s  Email:    

Polo  Shirt  (Men’s  sizing)   S   M   L   XL   XXL  

Young  Ladies  Shirt  (Women’s  sizing)   S   M   L   XL  

I  understand  that  in  order  to  be  a  member  of  Los  Amigos  in  Good  Standing,  I  am  required  to  abide  by  the  Standing  Rules  of  Los  Amigos.    I  further  understand  that  I  must  complete  a  minimum  of  50  Community  Service  hours  and  50  OIC  hours  over  the  applicant(s)  four  (4)  high  school  years  or  a  prorated  12.5  hours  of  Community  Service  hours  per  year  and  12.5  OIC  hours  per  year  if  membership  began  after  9th  grade.    Presidential  Award  Certificates  can  be  awarded  for  additional  hours  as  stated  in  the  standing  rules.      

Signature  of  Los  Amigos   Date   Signature  of  Mother   Date  

Los  Amigos’  Name  Printed   Mother’s  Name  Printed  

Mail to: Membership Chair, PO Box 2515, Palos Verdes Peninsula, CA 90274