Student Information:
Last Name *
First Name *
Address *
Apt #
City *
State *
Select state
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West
Wisconsin
Wyoming
Zip *
Email *
Phone *
Cell Phone #
What year do you graduate High School? *
Please select
2010
2011
2012
2013
2014
Name of School *
Extra Curricular Activities (Include offices held, clubs, sports and organizations):
What are your plans after Graduation?
Are you a Representative/Ambassador for another studio? *
Please Select
Yes
No
Will you be taking college courses your senior year? *
Please Select
Yes
No
Will you grant permission for Paul Floyd Photography to use your portraits in advertising? *
Please Select
Yes
No
Who is your school photographer
Please upload recent photo of yourself
Parent Information:
Last Name *
First Name *
Parents address if different from student
Apt #
City
State
Select state
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West
Wisconsin
Wyoming
Zip
Email
Phone
Cell Phone #
You must have parental permission to participate in the Paul Floyd Photography Senior Model Program. If selected for this unique program I will contact you soon with more information. Only a limited number of spots are open per school. Thank you for your application!