Instructions
• The FRYSC Coordinator should be the person completing and submitting the Page Day application form.
• Only ONE application per school should be submitted.
• All information must be filled out completely to be accepted, incomplete applications will not be accepted for the Legislative Page Program.
• Application deadline is December 6, 2024.
• Notifications that students are accepted as a Page will be mailed in JANUARY 2025. Please be prepared to come for the entire school day (10 – 6 PM) on the day that your student is a Page.
• Please do NOT call your legislator to ask about the date or the plan with them, we will do all of that for you.

Goals
The FRYSCKy Coalition has (3) three fundamental goals by sponsoring the Legislative Page Program:
To provide 5th-12th grade students with real life situations relating to Social Studies Core Content 2.4 and 2.15.
Provide students who may not otherwise have the opportunity to participate as a Page.
To spotlight the role of the FRYSC in the educational process.

Important Dates
• Selecting student legislative pages is a long process. Students will not be notified until January 2025 that they have been selected to participate.
• Page days are held sometime in February and/or March 2025.
• We will not know exact dates until January.

Consent
The FRYSC Coordinator for each Page must get the following consents from the parent/guardian of each participating child/youth:
• I hereby give permission for my child to participate as a Page as assigned in the Kentucky State Legislature during the 2025 Session. I understand I am responsible for transportation per the regulations of my child’s school district.
• I hereby give permission for the taking and publication of my child’s picture and name in public media.

Question Title

* 1. Enter your FRYSC region number:

Question Title

* 2. Enter your county name:

Question Title

* 3. Student's First Name:

Question Title

* 4. Student's Last Name:

Question Title

* 5. Student's Mailing Address:

Question Title

* 6. Name of School Attending:

Question Title

* 7. Student's Current Grade

Question Title

* 8. Student's Gender

Question Title

* 9. Student's Birthdate:

Question Title

* 10. Student's Current Age:

Question Title

* 11. Parent/Guardian's First Name:

Question Title

* 12. Parent / Guardian's Last Name:

Question Title

* 13. Parent/Guardian's Primary Phone #:

Question Title

* 14. Parent/Guardian's Email Address:

Question Title

* 15. Prior Experience as Page:

Question Title

* 16. Name of FRC/YSC Center:

Question Title

* 17. First Name of FRYSC Coordinator:

Question Title

* 18. Last Name of FRYSC Coordinator:

Question Title

* 19. Coordinator's Email Address:

Question Title

* 20. Coordinator's Phone Number (preferably cell #):

Question Title

* 21. Student's Extracurricular Activities:

T