Name: ______________________

Address: _____________________

Telephone: ( ___ ) _____________

Email: _______________________

Date of Birth: _________________

For Lucia applicants only: In addition to the above, all Lucia applicants must also:

• write an essay describing their Swedish heritage, special interests and why they want to represent SCH in Sweden, and
• include a current photograph with their application.

The Swedish Club of Houston

c/o Marie Teahen

23114 San Salvador

Katy, Texas 77494