SENIOR'S INFO:

Name

First Name

Last Name

Facebook Name / Instagram

High School:

Phone

(###)

###

####

MOM'S INFO:

(if applicable)

Name

First Name

Last Name

Phone

(###)

###

####

DAD'S INFO:

(if applicable)

Name

First Name

Last Name

Phone

(###)

###

####

ABOUT YOU:

Clubs & Activities

Check any clubs or activities you have participated in during your time in High School

Chess Club

Debate Team

Theater

Student Government

Yearbook

Model UN

Other

Awards & Achievements

List any accomplishments during your time in High School (i.e.; Honor Roll, National Honor Society, etc...)

Volunteer and Service Work

Have you worked with any organizations such as Habitat for Humanity, raised money for a benefit race, been a Big Brother or Big Sister, etc...?

Senior Project?

Have you done -- or still working on -- a senior project? Maybe you have a cool art installation, a research project, or travel plans?

Plans for Next Year!?

What are your college plans? Any internships lined up? Summer jobs?

"What Do You Want To Be When You Grow Up?"

Yes, the DREADED QUESTION! But we're dying to know, too-- any big hopes and dreams for the future?

What Makes You YOU?

What unique attributes do you have? Fun facts about yourself, something silly or something serious-- tell us! Do you have a pet iguana; can you speak five languages, have you been to any foreign countries? The sky is the limit :)

Authorization Signature / Model Release:

By typing your name below, you hereby consent to and authorize Bettinger Photography to use any and all photography, along with your name, from your portrait session(s), enlargements of the same, in studio advertising, exhibits, including, but not limited to seniorpix.com, bettingerphoto.com, websites, facebook, and any other social media, without any compensation from you:

Date

YYYY

Thank you! We can't wait to do your senior portraits!