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(IT)Computer Information Systems (CIS) Program of Study
Student Information
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Email
*
Your email
Last Name:
*
Your answer
First Name
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Your answer
Address
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Your answer
Phone Number
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Your answer
Current Grade Level
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9th
10th
11th
12th
Student’s Cumulative Grade Point Average: (on a 4.00 scale)
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Your answer
Date of Birth:
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MM
/
DD
/
YYYY
School Currently Attending:
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Your answer
Boundaries High School:
http://gis.pgcps.org/schoolfinder/findschool2.asp
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Your answer
Student ID#
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Your answer
Gender:
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Female
Male
Prefer not to say
Other:
Ethnic Background:
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African-American
Caucasian
Native American
Hispanic
Prefer not to say
Other:
Parent/Guardian Last Name:
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Your answer
Parent/Guardian First Name:
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Your answer
Parent/Guardian Phone:
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Your answer
Parent/Guardian Email
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Your answer
Parent/Guardian Consent:
*
I consent to have my child interviewed for placement consideration in the Computer Information Systems (CIS) Program.
I verify that the information provided on this application is accurate to the best of my knowledge.
Required
Parent/Guardian Signature:
*
Your answer
Date:
*
MM
/
DD
/
YYYY
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