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YES <br />LARGE SCREEN TV <br />DANCE FLOOR <br />TABLES (CARDS OR <br />Games <br />SOFAS <br />EASY CHAIRS <br />OTHER <br />lt/r'4 ,~ :z. <br />:. <br />33~ 9!'~6 <br />3 a r~ ~t ~f °1 a <br />a s? ~o~o <br />~e~~ ~~ ~u <br />~ ~ o ~3~a <br />NO No opinion <br />~ 1 ~' <br />17 ~ <br />l~`~ ~ 3 <br />~~ <br />1~ ~2. <br />SPECIAL ACTVITIES <br />SELF DEFENSE CLASS I ~~ ~ ~?~O <br />KARATE ~ 53 ~ ~ D <br />TAI KWAN DO i ~~ 'E='''F3 <br />MAKE-UP AND 1 S S ~ ~ ~A <br />Hair styles <br /> <br />1st AID & CPR <br />f f ~ / <br />.~{2+~~:;! <br />OTHER ~ <br />J ~ r <br />~, _~ Vic. ~ PJ .`.~': ~ a. i^ u C c.w:-~ ~ J r r ,.: j <br />6th <br />Present Grade in School (00 <br />11 12 <br />Age ~ 2• ~ l <br />Male aJ~ <br />When the lounge opens <br />I will come <br />I might come <br />I will not come <br />The lounge should be open to students from age 12 - 15 only <br />Agree a ~ 3 <br />Disagree 7 <br />Suggested Ages: <br /> <br />Suggested Names: <br />t <br />'I I,t_ t lu:~ <br />/t <br />1 I '-~ <br />~ ~'i <br />~~.;. <br />~ ~~1' <br />P <br />.~ <br />~,. _ . <br />7th <br />t `-~ ~, <br />~~ <br />{~ <br />~_ <br />~O <br />~~ <br />8th <br />~~5 <br />13 14 15 i;. <br />Female ~~~ <br />1 Y; e_ i ~~~ :i_'1~ f <br />r ;nK ~--i J`(~ <br />r' i <br />(~'K. 1, ''~~titi:~'[" ,r~C>ll~l~li~iK-1 ~FCi'~ (\i ~^:.-`V~ 'l <br />_.., <br />TC~1'l i~~~:~r,'~ :)~..~ ~ bon, s~t.t•, j 4-it's,' 'ti~:t'~ <br />/ .•~ <br />ii;,. f ,•~.. <br />f':~J: . <br />