DFCA Member Application – Information - Drug Free Clubs of America

New Member Information

Student Information:

First Name

Last Name

Birthday

Homeroom #

School

HS Graduation Year

Gender

Email

Student Phone # Format: 10 digits {Not Required: +1, (), -}

Student Address:

Street

City

State

Zip Code Format: 12345 or 12345-1234

Parent/Guardian 1 Information:

Parent/Guardian consent is required for Drug Free Clubs of America membership

First Name

Last Name

Email

Cell Phone # Format: 10 digits {Not Required: +1, (), -}

Other Phone # Format: 10 digits {Not Required: +1, (), -}

Other Phone Type

Address Same as Student?

Street

City

State

Zip Code Format: 12345 or 12345-1234

Provide Second Parent Information?

Parent/Guardian 2 Information:

First Name

Last Name

Email

Cell Phone # Format: 10 digits {Not Required: +1, (), -}

Other Phone # Format: 10 digits {Not Required: +1, (), -}

Other Phone Type

Address Same as Student?

Street

City

State

Zip Code Format: 12345 or 12345-1234

©2023 Drug Free Clubs of America. All Rights Reserved. Privacy Policy.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.