MSK Civil Rights Team
Student Application

If you are interested in being a member of the MSK Civil Rights 
Team, complete this application and return it to Mr. Willis 
(Rm.407), Mrs. Binger (Guidance Office), Mrs. Selsby (Guidance 
Office), or Mrs. Brunelle (Main Office).

Position: Civil Rights Team Student Representative

Qualities:
*Friendly
*Responsible
*Thoughtful
*Trustworthy
*Good Listener
*Models Respect for Self and Others
*Models Openness, Tolerance, and Acceptance

Name ________________________________________________________

Team ________________________________________________________

Advisor ______________________________________________________

Activities (clubs, sports, interests) 
_________________________________




Why do you want to serve as a Civil Rights Team Student 
Representative?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________

Teacher Recommendation: You are required to get one teacher 
recommendation to be considered for membership.

Yes, I recommend _____________________ as a Civil Rights Student 
Representative.

Teacher Comments: 
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________

Teacher�s Signature _____________________________________________

The MSK Civil Rights Team will meet regularly.  We will provide a 
healthy snack and encourage members to bring a snack to share.  

The Civil Rights Team will meet during late Start Wed. 8-9am (Bi-
Weekly, Opposite Student Voice). If this creates a conflict in your 
schedule please consider turning in the application, as we do meet 
occasional in the afternoons throughout the school year.


Identifying a meeting time is a struggle as teachers, students, and 
families navigate other school and community commitments.  
Parents/Guardians please answer the following questions regarding 
transportation by circling your choice.

Would you be able to arrange transportation for your student on Late 
Start?    YES or NO
Would you be willing or able to participate in a carpooling 
program?              YES or NO     

Parent/Guardian Signature _______________________________________

Student Applicant Signature ______________________________________

Thank you for your interest in the MSK Civil Rights 
Team!!!!!!!!!!!!!!!!