Tuscaloosa CollegeFirst Registration Summer 2018
Please contact Katelyn Dodd with any questions (kdodd@impactamerica.com).
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Student Information
First Name *
Last Name *
Preferred Name *
This name will appear on student's name tag and registration materials.
Student Email Address *
Please put the best email address we can use to contact you about your application status.
Gender *
Race/Ethnicity
Clear selection
High School Name *
Selections will be made on a first-come, first-served basis, but we reserve the right to revise the selection process to ensure students come from a diverse representation of schools throughout the Tuscaloosa area.
Grade Level for 2018-2019 School Year *
Mailing Address
We will use this address when sending the welcome packet and required registration forms prior to the Institute.
Street Address *
City *
State *
Zip Code *
Parent/Guardian Contact Information
Parent/Guardian First Name: *
Parent/Guardian Last Name: *
Parent/Guardian Phone Number (with area code): *
Format: XXX-XXX-XXXX
Parent/Guardian Email Address: *
Emergency Contact Name (if different from Parent/Guardian):
Emergency Contact Phone Number (if different from Parent/Guardian)
CollegeFirst Institute Course Selection
CollegeFirst offers courses in Biology, Calculus, Chemistry, Computer Science Principles and English Language. Please rank these classes in order of preference. *
Every effort will be made to assign students to their first choice; however, course assignments will be based on available space.
1st Choice
2nd Choice
3rd Choice
4th Choice
5th Choice
Biology
Calculus
Chemistry
Computer Science Principles
English Language
Students who drive themselves to the Institute may need a UA parking permit. We provide permits at no cost to students. Will you need a parking permit? *
CollegeFirst will take place June 4 - June 21, 2018. Students will attend Monday through Thursday from 8:00 am to 12:15 pm. Please list any planned absences (family vacation, sports practice, etc.). Include date(s) and explanation.
Please list any special accommodations you would the CollegeFirst team to be aware of, including dietary restriction, vision impairment, physical disability, etc.
Any and all information will be kept confidential and will only be shared with the necessary parties.
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