E-School For Girls 2021 Application
Please answer every question fully and to the best of your ability.
Email *
First Name *
Last Name *
Age *
Date of Birth *
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Female *
Race/Ethnicity *
Home Address *
City, State, and Zip Code *
Cell Phone Number *
Emergency Contact *
Emergency Contact Email *
Emergency Contact Phone Number *
Will you be a first generation college student? *
Were you eligible to receive free or reduced cost lunch at your school? *
Name of High School *
High School Address *
Current Grade *
High School Guidance Counselor or College Advisor *
High School Guidance Counselor or College Advisor's email address
GPA (100 point scale) *
PSAT/SAT Reading Score *
PSAT/SAT Math Score
ACT Composite Score
Extracurricular's (Clubs, Sports, Jobs, etc.) *
Short Answer: Please answer the following two questions in no more than 300 words. Please describe your career goals (max 300 words) *
What do you hope to gain from attending our program (E-School for Girls)? (max 300 words) *
How did you hear about us? *
Signature (Type Name)
Date Completed *
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