YOUTH SPONSORSHIP ENTRY FORM  

(please print)

APPLICANT INFORMATION  

NAME:____________________________________________________________ 

ADDRESS:________________________________________________________  

CITY:_____________________________________________________________

STATE:________        ZIP:___________________________________________  

YOUTH ORGANIZATION:__________________________________________  

YOUTH ORGANIZATION ADDRESS:_________________________________  

TELEPHONE NUMBER:____________________________________________ 

Signature_________________________________________________________ _

MEMBER INFORMATION

  NAME:___________________________________________________________  

ADDRESS:_______________________________________________________ _  

CITY:_____________________________________________________________

STATE:________        ZIP:___________________________________________ 

TELEPHONE NUMBER:___________________________________________  

WORK LOCATION:_______________________________________________

 I am a member in good standing of CWA, Local 9588.

 Member’s signature:_______________________________________________