College Prep Conference Online Registration
Register for the ESU Scholars, Inc. College Prep Conference June 13 - 15, 2018 PLEASE make payment on our WEBSTORE
Email address *
Student Last Name *
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Student First Name *
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Student Cell Phone *
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What is your Career Goal? Or Adult what is your Current Career? *
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What is your T-shirt Size? *
Type of Participant *
ESU Scholars College Prep Conference Previous Participant *
School Level or Status *
High School Graduation Year *
Grade for Fall of This Year *
Grade Point Average Range *
ACT Total Score Range *
School Name or Adult Company Name *
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Date of Birth *
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Age *
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Street Address *
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City *
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State *
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Zip Code *
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Home Phone *
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Guardian 1 First and Last Name *
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Guardian 1 Cell Phone Number *
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Guardian 1 Email *
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Guardian 2 First and Last Name *
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Guardian 2 Cell Phone Number *
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Guardian 2 Email *
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School Counselor Name *
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School Counselor Phone
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School Counselor Email Address
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School Counselor Phone Number
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How did you Hear about the College Prep Conference?
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Thank you for Registering for our College Prep Conference. Please make your payment at our Online store: http://www.esuscholars.org/apps/webstore
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