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College Readiness, The Path Starts Early: Empowering Students to Prepare for College Economics from the Inside/Out Workshop - Student Registration Form
Please complete this registration form to finalize your registration for the retreat.
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* Indicates required question
First Name (Student) *
*
Legal name.
Your answer
Last Name (Student) *
*
Legal Name.
Your answer
Student Phone Number (Home or Cellular)
*
Your information wil not be sold or used for the purpose intended.
Your answer
Student Mailing Address
*
Street Address, City, State & Zip Code.
Your answer
What High School Do You Attend?
*
Please specify if you attend a Public, Private, or Charter School
Your answer
Current Grade?
*
Your answer
Are you apart of a College Readiness Program?
*
Please choose from the choices below.
HCC CROP
USF CROP
Upward Bound
Community Base Program
In School Mentoring Program
Sorority/Fraternal Youth Program
Religious Base Youth Program
Student Career Goal / College You Would Like To Attend?
*
Your answer
Student Email Adddress*
*
Plese provide parent email address if the student does not have one.
Your answer
Emergency Contact*
*
Name, Phone, & Relationship (Parent, Guardian, etc.)
Your answer
How did you hear about this event?
*
Tell us theirname and organization so that we can thank them. This also lets us know which marketing efforts are successful.
Friend
Family
School Teacher
Mentor Organization
(YBP) Young Black Professionals
(CROP) College Reach-Out Program Staff
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