CHEER TRYOUT PACKET 2018-2019 Thank you for your interest in the Morgan County Middle School Cheerleading Squad. **Pre-Tryout Meeting - April 12 @ 5:30 at MCES** Enclosed you will find the information needed for a successful try-out. Be sure that all of the information asked for that is included in this packet is turned in by the first day of clinics. Failure to comply will result in dismissal from clinic and tryouts. Read all of the information carefully. We take pride in the cheer program at Morgan County Middle School and expect athletes to adhere to the rules. If you have any questions, please feel free to contact the coaches. We know there are a few spring sports conflicts. Please speak with a coach if any other extenuating circumstances prevent you from being present during tryout week. This is very important. We will videotape tryout material and share it online. This will give everyone the same advantage. Tryouts are closed to family and friends. This is for the safety of all concerned. This is a very stressful time for those involved. Be sure that you are getting plenty of sleep and eating healthy. You will be using a lot of energy learning the routines. Anxiety burns calories too, so please do not diet at this time. We would also recommend that you be in some sort of conditioning routine to help build your stamina and improve flexibility. We wish you all the best of luck. Thank you again for your interest. See you at the clinic. ELIGIBILITY: ❖ All students must have a current physical on file. *Physicals at MCMS on May 2 @ 3:45* ❖ All students must be school eligible. Sincerely, Coach Reaves and Coach Barrett [email protected][email protected]1
Transcript
CHEER TRYOUT PACKET 2018-2019
Thank you for your interest in the Morgan County Middle School Cheerleading Squad.
**Pre-Tryout Meeting - April 12 @ 5:30 at MCES**
Enclosed you will find the information needed for a successful try-out. Be sure that all of the information asked for that is included in this packet is turned in by the first day of clinics. Failure to comply will result in dismissal from clinic and tryouts. Read all of the information carefully. We take pride in the cheer program at Morgan County Middle School and expect athletes to adhere to the rules. If you have any questions, please feel free to contact the coaches. We know there are a few spring sports conflicts. Please speak with a coach if any other extenuating circumstances prevent you from being present during tryout week. This is very important. We will videotape tryout material and share it online. This will give everyone the same advantage. Tryouts are closed to family and friends. This is for the safety of all concerned. This is a very stressful time for those involved. Be sure that you are getting plenty of sleep and eating healthy. You will be using a lot of energy learning the routines. Anxiety burns calories too, so please do not diet at this time. We would also recommend that you be in some sort of conditioning routine to help build your stamina and improve flexibility. We wish you all the best of luck. Thank you again for your interest. See you at the clinic.
ELIGIBILITY:
❖ All students must have a current physical on file. *Physicals at MCMS on May 2 @ 3:45* ❖ All students must be school eligible.
About Competition: 6th, 7th, and 8th graders can choose to try out for the competition squad. This squad will be composed of 15 competition cheerleaders. Requirements for Competition: One of our major goals for this year’s squad is for every girl to have a standing handspring and at least a running back handspring. All girls need to be able to complete a three consecutive jump sequence (Pike, Hurdler, Toe-Touch). Football Spirit/Competition: Competition cheerleaders are not automatically on a spirit squad… they will have to tryout for the spirit squad along with all other girls. Competitive cheerleaders are not required to cheer on a spirit squad.
Dates/Times: ● Tuesday, May 1 - Thursday, May 3 @
4:00-5:30 ● Tryouts: May 4 @ 4:00
What you can expect during the season:
● Mandatory Meeting on May 9 @ 5:30 (1st NON-REFUNDABLE payment due $100)
● Varsity Fitting on May 9 o 4:00-6th graders o 4:30-7th graders o 5:00-8th graders
● Conditioning – o May 14 @ 4:00-5:00 o May 16 @ 4:00-5:00 o May 21 @ 4:00-5:00 o May 23 @ 4:00-5:00 o May 30 @ 4:00-5:00 o June 4 @ 9:00-11:00 o June 6 @ 9:00-11:00
● Choreography Camp- June 11-12 @ 8:00-4:00 (Lunch @ 12:00-1:00)
● Back to School Rally - July 21 ● In season practices – every day during the
week once school starts until 6:00 and any other “called” practice
● Competitions – There will be very few Saturday mornings off during the season beginning Sept. 16. The competitions start early but are usually over in the afternoons.
● Fundraisers- See “Fundraisers” Section ● Rules:
o Hair will be up for every practice and competition.
o All jewelry will be taken out (even new piercings)!
o No nail polish. Finger nails must be trimmed.
2
EVERYTHING YOU NEED TO KNOW ABOUT
MCMS SPIRIT SQUADS
You are the spirit leaders of the school. You need to make sure you have your game face on at all games. You are leading the crowd. You are attentive to the athletes on the field or court at all times. You are their biggest fans!
Football: The Football cheerleaders will cheer at all Football games, pep rallies, back to school rally and participate in local parades. You will also make signs for fall and winter sports. There will be approximately 18 girls on the squad.
Basketball: The Basketball cheerleaders will be divided into 2 squads (16-18 girls total). The squads will rotate cheering at regular season basketball games. You may cheer at all games. If you would like to, please indicate on tryout packet. All Basketball cheerleaders are expected to cheer at all pep rallies during the spring. You will also make signs for spring sports.
Tryout Dates/Times: ● Tuesday, May 1 - Thursday, May 3 @
4:00-5:30 ● Tryouts: May 4 @ 4:00
Expectations during the season:
● Mandatory Meeting on May 9 @ 5:30 (1st NON-REFUNDABLE payment due $100)
● Varsity Fitting on May 9 o 4:00-6th graders o 4:30-7th graders o 5:00-8th graders
● FCA Spirit Camp - June 25-28 @ Emmanuel College
● Fundraisers- See “Fundraisers” Section ● In season practices
o FOOTBALL - Once school starts, we will practice Mondays and Wednesdays (4:00-5:00) until football games start. Once football games start, every Monday (4:00-5:00).
o BASKETBALL - Practices will start in November. We will review/learn cheers prior to the first basketball game. Once basketball games start, we will practice as needed.
● RULES o Hair will be up for every practice and
game. o All jewelry will be taken out (even
new piercings)! o No nail polish during games. Finger
nails must be trimmed.
3
TRYOUT INFORMATION: 1. What to wear:
a. Something comfortable and that fits you properly. b. No baggy clothing or too small shirts/shorts c. Tennis shoes d. The day of tryout please wear black shorts and a white t-shirt. e. Hair must be in a secure ponytail the whole time.
2. No Jewelry:
a. This includes belly rings and multiple earrings! 3. What to bring:
a. WATER, WATER, WATER b. Make sure you EAT BEFORE COMING. c. Cheer packet with all of the information filled out.
What forms need to be signed before the 1st day of tryouts?
1. A current physical must be on file in the athletic department (Coach Franklin) 2. Cheer Contract 3. Concussion Awareness 4. Warning of Risk 5. Information and Medical Release Form 6. Alternate Transportation Form
See RUBRIC for tryout requirements and to see how girls will be scored. Team Selection: The coaching staff will be evaluating applicants throughout the try-out clinic and from the videos recorded on tryout day. A rubric will be used to evaluate athletes based on performance, technique, attitude, teamwork, work ethic and positions that need to be filled. For example: we will be looking for a specific number of bases, back and/or flyers (for competition); we will be looking for girls who are coachable and willing to work with coaches to become a better cheerleader for the team; we are looking for girls who want to be here and understand that it is a privilege to be on a cheer squad. **Spectators will not be permitted in the gym during tryouts. **All squad decisions are final.
4
ESTIMATED Costs *Note: We appreciate your patience and support while we make our final decisions. Costs are subject to change during this process. We will have fundraisers to help cover the cost.
Cheerleading is considered an extracurricular activity and is subject to all the rules and regulations
stated in the Morgan County Middle School Activities Handbook. Students and parents must sign all
appropriate contracts and consent forms and pay all fees prior to the student participating in the
cheerleading program (the MONDAY before the FIRST football game). Being a member of the cheerleading squad is a privilege, and all team members are expected to
conduct themselves in an appropriate manner at all times and fully participate in all aspects of
cheerleading including practices, fundraising activities, pep assemblies, games, poster making, locker
and hall decorating, and any other scheduled spirit events. We ask all girls to be aware of the
rules and know that they are held accountable for breaking any of the rules set below.
Remember, it doesn't just affect you but the WHOLE team if you are not following the
rule.
1) BE ON TIME! And DON'T LEAVE EARLY!
A tardy is defined as the arrival to a practice or game of more than 5 minutes after the
appointed time. Cheerleaders must be at practices and games at the scheduled time READY TO
GO..not arriving AND EATING or getting dressed. Practices will start promptly at 4:00. All
stretching should be done and mats rolled out and taped by then. Anyone choosing to
leave early (or walking out) for any practice or game without coaches permission will have
to meet with the coach before returning to the squad.
2) ATTENDANCE
● Excused absences (school sponsored events, medical appointments due to illness or injury, etc)
must be approved by the coach ONE WEEK in advance. Please notify the coach directly as soon as
possible in the event of an illness or family emergency or the absence may be counted as
unexcused.
● SPIRIT
o An excused absence will result in conditioning and/or an additional job
needed to be done (coaches discretion) for our cheer squad. (clean
gym/bus/field, carry equipment, clean cheer room)
o An unexcused absence will result in a one game suspension.
o Two or more unexcused absences may be grounds for removal from the
squad.
● COMPETITION
o An excused absence will result in conditioning and/or an additional job
needed to be done (coaches discretion) for our cheer squad. (clean
gym/bus/field, carry equipment, clean cheer room)
o An unexcused absense from competition practice will result in one
competition event suspension and possibly losing their place on the mat.
o Any unexcused absence from a competition event will result in removal
from her spot on the mat.
● OTHER RULES
o MCMS requires that athletes attend a half day of school in order to participate in the
event that evening.
o Cheerleaders must be picked up within 15 minutes after each event/practice or after
returning from an away event. Continued late pick up may result in the cheerleader’s
inability to participate.
7
Excused absences include:
● Sick-out of school with doctor’s note
● Death in the family
● Any other absences approved by the
coaches 1 week in advance
Unexcused absences include:
● Other sport practices
● Hair Appointment/nail appointment
● Family Trips/Events (unless approved
by the coaches well in advance)
3.) BE A TEAM PLAYER!
● If an athlete is suspended for disciplinary or attendance reasons they will be expected to attend
any competitions/games, but may not participate. You will have to remain with the coach at
all times and not socialize with the fans.
● If athlete is suspended from school, they will not be able to attend or particpate in the even at all.
● In the event the athlete is unable to physically participate, they must still attend
competitions/games. They will also be expected to attend practices and participate in non-physical
activities. Again, the athlete will remain with the coach and not mingle with the fans.
● When you are upset about something, do not take it out on others. Please feel free to
ask for a moment. Please adhere by the 24 hours rule. After 24 hours, you will have had time to
settling down before speaking with the coach/and or cheerleader. Watch your attitude towards the
coaches, team mates and what's being asked of you during this time. Be careful about posting
inappropriate comments on FB/Twitter/Instagram/Snapchat, etc. bashing coaches
and teammates. Disciplinary actions will be taken if necessary for violation.
● Inappropriate behavior will be grounds for removal from the squad.
● Respect coaches and teammates at all times.
● Regular teacher evaluations to ensure proper balance inside and outside the classroom.
● If you choose to quit the team before the season is over, you will NOT be allowed to try out the
following year (8th graders will NOT be allowed to tryout for high school).
● If you QUIT the squad, you will NOT be allowed to try out for the following cheerleading season.
4) CELL PHONE RULES:
● Cell phones are to be turned off and/or left away from the performance floor and practice area.
The coach will have a cell phone available in case of emergency. Cell phones will not be allowed
during our minute breaks at practices! Games: You may only check your cell phones at halftime of
games. They must remain in your bag! Competitions: Coaches will take up all phones and put
them in her bag. Your phone will be given back to you after we compete.
5) DRESS AND BEHAVE APPROPRIATELY!
● You need to have all parts of the uniform (uniform, BLACK bloomers, bow, white
socks, shoes, cheer warm up pants and cheer jacket, etc.) for every game or
competition, according to what is decided by the coach. Uniforms must be kept in
clean and professional condition.
● Spirit: We will dress as a uniformed team even during cold weather. Warm-ups (pants and
jacket) and body liners are provided for cold weather. When arriving to games, we will wear our
cheer shoes. No boots or sandals. NON- NEGOTIABLE!
● Competition: We will enter schools fully dressed! On cold days, we will wear our warm-ups and
get dressed at the competitions. Other than that, our uniforms AND cheer shoes will be worn into
the buildings zipped- unless told otherwise prior to the competition. We will also wear our
uniforms on the floor during awards without jackets...do not change!! DO NOT sit in the stands
with unzipped body liners. You may wear a t-shirt over your uniforms while watching others
perform but they need to be zipped and ready to go by awards. NON- NEGOTIABLE!
8
● NO jewelry is to be worn during any practices or performances. This includes any jewelry or
piercings of any kind.
● Hair must be worn off the shoulders and away from the face at all times. Only soft hair bands may
be used - Small clips may be used but must be securely fastened. For competitions, hair will be
worn in a high ponytail with the bow on top.
● Nails must be kept trimmed to sports length and filed (no longer than the fingertips). NO
fingernail polish is allowed while cheering games and performances. (Even during
BASKETBALL!!!)
● No glitter is to be worn on face, body, hair or uniform at any time.
● Shoes must be worn at all times during practices and performances.
● Chewing gum is not allowed during any practice or performance.
● Uniforms must be kept clean and in good condition. If uniforms are not returned or returned in
poor condition, the athlete will be charged for appropriate mending/cleaning or replacement
costs. DO NOT ALTER WITHOUT COACHES PERMISSION!! You will have to pay to have
it let out and sewn back to original state if done so without permission! Any alteration that cannot
be reversed will result in the cheerleader purchasing a replacement.
● When in uniform (after performances/games), you will need to make sure you are modeling
appropriate behavior. You are representing your squad and the school.
● No inappropriate behavior/pictures on FB/Twitter/Instagram/Snapchat, etc.. You’re the face of
the school and cheer squad. Represent us all well.
6) OUT-OF-TOWN PERFORMANCES/GAMES
● Cheerleaders and coach/chaperons will ride together to and from games and /or competitions
when traveling to out -of-town performances. This includes those injured. If a girl has to ride back
with a parent, they must sign the girls out before leaving the games/competitions. Please make
sure you have have returned the Approved Providers of Alternate Transportation Form. We will
not let your child leave with anyone not on that list.
7) Line of Contact
● It is our goal to work together to make this a successful year. To do this, we must respect the
proper line of contact.
○ Parents and cheerleaders: The first contact is the coach. Parents and cheerleaders are
expected to bring problems or concerns to the coach first. If the matter is not resolved
at that point, then another party may be brought in.
■ Cheerleader to coach- cheerleader to parent- parent to head coach- parent to
athletic director
○ Coaches: The first contact is the cheerleader. Depending on the severity of the issue,
the parent may also be notified at that time.
■ Coach to cheerleader-coach to parent- coach to head coach- coach to athletic
director
8) Payments
● It is essential payments be made on time so we may be able to make appropriate orders and
have them delivered on time.
● Payments must be kept current. Any cheerleader with an overdue balance will not be allowed
to participate until the account is brought current.
9) Practices
● All practices will be closed practices to eliminate any distractions.
9
Any violations of the above rules will result in disciplinary action.
● conditioning and/or an additional job needed to be done (coaches discretion) for our
cheer squad.
● meeting with coaches
● meeting with parents (and administration- if needed)
● severe and/or continuing offenses could include suspension or removal from the
squad.
**DISCLAIMER: Guidelines may be revised periodically and the most current
information will be on the website.**
These guidelines have been established with the goals of safety, clear communication
between coaches, athletes and parents, and fairness to all squad members. By signing
this contract, the athlete and parents indicate a knowledge of the contents of this
contract, including the potential risks involved, knowledge of the Morgan County
Middle School Activities Rules and Regulations and the willingness to abide by them.
Please sign only after you have read and understand the “Athlete Contract” and ARE
WILLING TO AGREE WITH AND SUPPORT ITS ENFORCEMENT.
Signature of Parent or Guardian __________________________ Date ____________
Signature of Athlete ___________________________________ Date _____________
10
STUDENT/PARENT CONCUSSION AWARENESS FORM
SCHOOL: Morgan County Middle School DANGERS OF CONCUSSION Concussions at all levels of sports have received a great deal of attention and a state law has been passed to address this issue. Adolescent athletes are particularly vulnerable to the effects of concussion. Once considered little more than a minor “ding” to the head, it is now understood that a concussion has the potential to result in death, or changes in brain function (either short-term or long term). A concussion is a brain injury that results in a temporary disruption of normal brain function. A concussion occurs when the brain is violently rocked back and forth or twisted inside the skull as a result of a blow to the head or body. Continued participation in any sport following a concussion can lead to worsening concussion symptoms, as well as increased risk for further injury to the brain, and even death. Player and parental education in this area is crucial – that is the reason for this document. Refer to it regularly. This form must be signed by a parent or guardian of each student who wishes to participate in GHSA athletics. One copy needs to be returned to the school, and one retained at home. COMMON SIGNS AND SYMPTOMS OF CONCUSSION Headache, dizziness, poor balance, moves clumsily, reduced energy level/tiredness Nausea or vomiting Blurred vision, sensitivity to light and sounds Fogginess of memory, difficulty concentrating, slowed thought processes, confused about surroundings or game assignments Unexplained changes in behavior and personality Loss of consciousness (NOTE: This does not occur in all concussion episodes.) BY-LAW 2.68: GHSA CONCUSSION POLICY In accordance with Georgia law and national playing rules published by the National Federation of State High School Associations, any athlete who exhibits signs, symptoms, or behaviors consistent with a concussion shall be immediately removed from the practice or contest and shall not return to play until an appropriate health care professional has determined that no concussion has occurred. (NOTE: An appropriate health care professional may include, licensed physician (MD/DO) or another licensed individual under the supervision of a licensed physician, such as a nurse practitioner, physician assistant, or certified athletic trainer who has received training in concussion evaluation and management.
a) No athlete is allowed to return to a game or a practice on the same day that a concussion (a) has been diagnosed, OR (b) cannot be ruled out. b) Any athlete diagnosed with a concussion shall be cleared medically by an appropriate health care professional prior to resuming participation in any future practice or contest. The formulation of a gradual return to play protocol shall be a part of the medical clearance. c) It is mandatory that every coach in each GHSA sport participate in a free, online course on concussion management prepared by the NFHS and available at www.nfhslearn.com at least every two years – beginning with the 2013-2014 school year. d) Each school will be responsible for monitoring the participation of its coaches in the concussion management course, and shall keep a record of those who participate.
I HAVE READ THIS FORM AND I UNDERSTAND THE FACTS PRESENTED IN IT. SIGNED: ______________________________________ ____________________________________ (student) (parent) DATE: __________________________
11
Parent/Guardian Permission Form and Warning of Risk
PLEASE PRINT CLEARLY AND IN PEN. I give my permission for _________________________________________________________ to tryout and participate in the Morgan County Middle School Cheerleading Program and travel with the team and/or coach and/or other cheerleader parent. I understand the cost involved for my child to participate and agree to support my child accordingly. SERIOUS, CATASTROPHIC AND PERHAPS FATAL INJURY MAY RESULT FROM ATHLETIC PARTICIPATION. By its very nature, competitive athletics may put student athletes (cheerleaders) in situations in which accidents may occur. Athletic competition can result in accidents, strenuous physical exertion, and numerous other exposures to risk injury. Students and Parents must understand and assess the risks involved in such participation and make their choice to participate in spite of those risks. The obligation of parents and students in making this choice to participate cannot be overstated. There have been accidents resulting in death, paraplegia, quadriplegia and other serious permanent physical impairment as a result of athletic competition. Morgan County Middle School athletes will be instructed in proper techniques to be used in athletic competition and in the proper utilization of all equipment worn or used in practice and competition. Student/Athletes must adhere to that instruction and utilization and must refrain from improper uses and techniques. However, no amount of instruction, precaution, and supervision will totally eliminate all risk of serious, catastrophic, or even fatal injury. By granting permission for your Child/Athlete to participate in athletic competition, you, the parent or guardian, acknowledge such risk exists. By choosing to participate, you, the student/athlete, acknowledge that such risk exists. _____ I acknowledge that cheerleading is a sport that involves flyers, bases, and spotters. Flyers are lifted into stunts by the bases, with the safety-oriented spotters when needed. Bases and spotters are responsible for catching the flyers when stunts come down. Cheerleading also requires forceful motions, tumbling, voice projection, and jumping. The cheering area varies greatly from one location to another, outside or inside. Because of these conditions inherent to the sport, participating in cheerleading exposes an athlete to many risks of injury. Those injuries include, but are not limited to: death, paralysis due to serious neck and back injuries, brain damage, damage to internal organs, serious injuries to the bones, ligaments, joints, and tendons, and general deterioration of health. Such injuries can result not only in temporary loss of function, but also in serious impairment of future physical, psychological, and social abilities, including the ability to earn a living. _____ I acknowledge that even with the best coaching, use of the most advanced practice equipment, and strict observance of rules, injuries are still a possibility. _____ I acknowledge that it is vital that cheerleaders follow the coach’s skill instructions, training rules, and team policies to decrease the possibility of serious injury. We have read the information above concerning the risks of cheerleading and travel. We understand and assume all risks associated with trying out, practicing, cheering at games/competitions, and traveling. In signing this form, we assume the inherent risks of cheerleading and travel and waive future legal action by our heirs, estate, executor, administrator, assignees, family members, and ourselves. If any of the foregoing is not completely understood, please contact the coaches or Athletic Department for further information. Parent/Guardian Signature_____________________________________________ Today’s Date__________ Participant Signature_______________________________________________ Today’s Date___________
MCMS Cheerleading INFORMATION FORM & MEDICAL RELEASE FORM
12
REQUIRED FOR TRYOUTS
Circle all that apply: Competition Football Basketball Cheerleader Name: ____________________________ DOB: ___________ Grade: _________ Address: _________________________________________________________________________ Home #: ____________________ Cell #: ___________________ Email (not school):_____________________ Parent/Guardian: __________________________________ Contact #: ________________________________ Address (if different from cheerleader): __________________________________________________________ Mom Email: ___________________________ Mom Cell #: ________________________________________ Dad Email: ___________________________ Dad Cell #: _________________________________________ ********Emergency Contact******** Name: ______________________________________________ #:__________________________________ MEDICAL SITUATIONS: Please list below any medical situations about which the coach should be aware: ____________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________ INSURANCE and MEDICAL AID PROVISION: We do hereby give permission for the cheerleading coach to secure whatever emergency medical treatment my child needs at any time during practice, or home and away competitions. _____________________________ _____________________________ (Signature of Parent) (Signature of Cheerleader) I will assume financial responsibility for expenses involved in this treatment. Insurance Company _________________________________ Policy Number ______________________________________
13
Morgan County Charter School System 1065 East Avenue
Madison, GA 30650
Alternate Transportation Liability Acknowledgement Form
The Morgan County Charter School System is not always able to provide transportation for students to off-campus extracurricular school activities. In cases when bus transportation is not provided by the Morgan County Charter School System, it is the responsibility of the student’s parents or guardians to secure their student’s attendance at such activities. No students will be allowed to drive their personal vehicles to official events held away from home venues. In certain situations, a coach/sponsor may dismiss students to travel home from off-campus extracurricular activities with parents/guardians or other adults listed in the approved providers of alternate transportation section of this form. It is agreed upon that coaches/sponsors should not be held accountable when students who are authorized to use alternative means of transportation do so. The Morgan County Charter School System, its schools, officers, employees or agents shall not be responsible for any injury or loss arising out of a student’s transportation to or from the off-campus activity when such transportation is provided by the parent/guardian or an adult listed on the approved providers of alternate transportation form. Your student’s participation in off-campus extracurricular activities serves as your agreement to this policy.
14
Approved Providers of Alternate Transportation I hereby give my son/daughter, _____________________________, a member of the MCMS Cheer Squad, permission to travel to and from off-campus extracurricular activities with MCMS Cheer. I also give permission, if needed, for my child’s coach, _______________________ or _______________________, to drive him/her if needed. Name 1:_________________________ Relationship:_________________________
Cell #: __________________________ Last 4 SSN: _________________________
Name 2:_________________________ Relationship:_________________________
Cell #: __________________________ Last 4 SSN: _________________________
Name 3:_________________________ Relationship:_________________________
Cell #: __________________________ Last 4 SSN: _________________________
Name 4:_________________________ Relationship:_________________________
Cell #: __________________________ Last 4 SSN: _________________________
Name 5:_________________________ Relationship:_________________________
Cell #: __________________________ Last 4 SSN: _________________________
Name 6:_________________________ Relationship:_________________________
Cell #: __________________________ Last 4 SSN: _________________________
