Reynoldsburg High School Please print legibly your name as it is on your birth certificate and should appear on your diploma. (No Nicknames) Last Name First Name Middle Name Reynoldsburg High School 2017 Senior Activity Sheet Academy: __________________________________ Who do you want to pick to receive your diploma? (Print their name) (They MUST BE a current RHS High School Teacher/Staff Member) Please indicate your participation in an activity(ies) by checking (X) in the appropriate activity and year. Use the following letter(s) to indicate the position held: P-President, S-Secretary, T-Treasurer, CH-Chairperson, C-Captain, M-Member. Activities 9 10 11 12 Blood Donor Choir Chorale Cyber Patriot DECA Eastland Performing Arts Encoreocracy FEA Green Teens Human Trafficking Interact Club Leo Club Library Worker Marching Band Activities 9 10 11 12 National Honor Society Office Worker Powder Puff Player Prelude Orchestra Robotics Team Rube Goldberg Participant Senior Focus Group Student Government Symphonic Band Symphony Orchestra Theatre/Musical Wildfire Wind Symphony Yearbook Youth at the Booth Please complete front and back of the form.

Community/Volunteer Activities Last Name First Name Middle Name Sports 9 10 11 12 Baseball Basketball Bowling Cheerleader Cross Country Football Golf Sports 9 10 11 12 Soccer Softball Swimming Tennis Track & Field Volleyball Wrestling Community/Volunteer Activities ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Work Experience __________________________________________________________________________________________________________________________________________ What are your plans for after graduation? Examples: I plan to attend The Ohio State University – majoring in Forensic Science I plan to travel in Europe for a year, then attend college in Germany. I am enlisting in the United States Marines. ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ This form needs to be completed and returned to your Academy Office by March 17th. Any questions, please contact Mrs. Nash or the Senior Class Advisors: (LAHS) Mrs. Rettke wrettke@reyn.org (SUHS) Mr. Underwood WUnderwood@reyn.org