Form submitted successfully, thank you.
Error submitting form, please try again.
Your Full Name (required)
Your Email (required)
High School
Year of Graduation
Interests & Hobbies
Describe your personality
What are you involved in at school
Facebook URL (facebook.com/yourname)
Twitter URL (twitter.com/yourname)
Why would you want to be a Senior Rep?
How would you help promote Benj Haisch Seniors as a rep?
Why should I choose you as a rep?