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Name of Applicant *
Date of Birth *
Phone Number *
Home Address *
Name of Higher Education *
Will you be attending a 2 or 4 year institution? *
Name of Teamster Relative *
Employer (or past Employer for retirees) of Teamster Relative *
Last Four Digits of Social Security of Teamster Relative *
Please specify any years (Freshman,Sophomore,Junior,Senior) and the Office position held (President, Vice-Pres,Secretary,Treasurer) *
Please specify if you have been on Student Council (Junior Council, Senior Council), and which years. *
Please specify if you have made Honor Roll, or Honor Society, and which years *
Have you been in any Clubs? Please specify and list applicable years *
Have you been on any Committees? Please specify and list appliable years *
Have you received any awards? (Include Academic, Athletic, Community) *
Do you have any Publications? (Yearbook, Newspaper, Online, Other) *
Please list any musical activities (Band,Orchestra,Chorus,Other) *
Please list any sports, and the years in participation *
Please list any extracurricular activities (Church,Community,Civic,Political) *

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Teamsters Local 317
566 Spencer Street
Syracuse, NY 13204
  315-471-4164

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