2019 PowerUp Registration Form
PowerUp Fall 2019 is the ideal way to get plugged into your future. On Saturday, October 26, 2019 at UW Parkside from 8:30 a.m.-1 p.m., you and your parents/guardians will visit with college representatives and listen to experts who will show you how to find a clear path to college and your dream career.

For more information on this event, contact your high school counselor or Sabrina Morgan at 262-564-2362 or morgans@gtc.edu.

Please complete registration by Friday, October 18, 2019.

Transportation is available upon request - Kenosha residents only.
Student's first name: *
Your answer
Student's last name: *
Your answer
Student's address: *
Your answer
Student's email: *
Your answer
Student's phone number: *
Your answer
Student's school: *
Student's grade: *
Student's age as of Oct. 1, 2019: *
Your answer
Student's ethnicity: *
Student's preferred language: *
Student's gender: *
Parent/Guardian OR emergency contact first name(s): *
Please provide a name whether or not the parent is not attending so we have an emergency contact number on file.
Your answer
Parent/Guardian OR emergency contact last name(s): *
Please provide a name whether or not the parent is not attending so we have an emergency contact number on file.
Your answer
Parent/Guardian OR emergency contact email: *
Please provide an email whether or not the parent is not attending so we have an emergency contact number on file.
Your answer
Parent/Guardian OR emergency contact phone number(s): *
Please provide a phone number whether or not the parent is not attending so we have an emergency contact number on file.
Your answer
Refreshments will be served, please indicate any dietary restrictions you or your parent/guardian may have:
Your answer
Transportation needed (Kenosha residents only)? *
Please provide a phone number whether or not the parent is not attending so we have an emergency contact number on file.
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