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ULTRA Teen Choice
STAR Application
Apply to be an ULTRA Teen Choice STAR (Student Teaching Abstinence & Responsibility) using this form. STAR Guides must be high school graduates. Assistant STAR Guides must be in 10th, 11th grade or 12th grade.
First Name
Last Name
Gender
Male
Female
Date of Birth
Address
City
State
Zip
Home Phone
Email
Cell Phone
Employer
Employer Address
Position
School
Graduation Date
School City
School State
Reference Information
Title
Name
Address
Ctiy
State
Zip
Preferred Phone
Reference email
Please list any previous community service, school club leadership, mentoring or other relevant experience (drag the lower right corner to make the box bigger).
Do you agree that it is best for youth to abstain from sex before marriage? Give a brief explanation of your answer, if desired.
Why do you want to be a STAR Guide?
Please check each week that you are available (Please select at least 8 weeks): The time is 5 p.m. to 7:30 p.m.
February 12
February 19
February 26
March 4
March 11
March 18
March 25
April 1
April 15
April 22
Enter the Spam Protection code shown below:
I cannot commit to being a STAR Guide, but I will "audit" select weeks of the STAR Program
Have Questions?
Call Richard Urban now at 202-544-5081
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ULTRA Teen Choice
