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Fall Pre-College Camp Application 2016
Student Information
Email address *
Last name *
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First name *
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MSID# You may need to get this # from your Migrant TeacherYour answer *
Your answer
Date of Birth *
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High School *
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Incoming Grade *
GPA *
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Age *
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Gender *
Your Email *
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Address *
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City *
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Zip *
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Parent Name *
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Contact Number of Parent *
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Emergency Contact Name *
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Contact Number of Emergency Contact
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Tell us about your extracurricular activities in and outside of school. For example, class office, clubs, organizations, sports, hobbies, church, work experience, etc. *
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You are not done: You will need to complete the following forms once you have been accepted to the Pre College Camp. Information to acquire these forms upon acceptance to follow. 1) Permission Slip 2)Media Release Waiver 3)Medical Forms 4)High School Transcript. You will need to submit the forms for official submit of your application. Electronic Signature: Enter Your Full Name *By entering your name below you are attesting to the information you have entered in this application. As to the best of your knowledge, all information in this application in correct and accurate. *
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