U.S. Grant Applicant Demographic Info Form
Applicants to the U.S. Grant summer program are asked to complete this form in addition to completing the paper application form available on our website and also at area schools. This form does not replace your required paper application. However, this form gives us your contact information early so that we can contact you or your school if we need to during the admissions process.

This form is for both new and returning applicants. Questions with a red asterisk are required.

Good luck and we look forward to an exciting, creative and productive summer!

Applicant Information
Are you a New or Returning Grant Applicant? *
Please check the box that is most appropriate.
Required
Applicant First Name *
Your answer
Applicant's Middle Name
Your answer
Applicant's Last Name *
Your answer
Applicant's Date of Birth *
MM
/
DD
/
YYYY
Applicant's Race/Ethnicity
Please select all that apply
Applicant's Current School *
Your answer
Applicant's Current Grade in School *
Parent/Guardian Contact Information
Below are questions related to the parents/guardians of the applicant.
Parent/Guardian's Full Name (First and Last) *
Your answer
Parent/Guardian's relationship to the applicant *
Your answer
Parent/Guardian's Street Address *
Your answer
Parent/Guardian's City of Residence *
Your answer
Parent/Guardian's State of Residence *
Your answer
Parent/Guardian's Zip Code *
Your answer
Parent/Guardian's Phone Number *
Please list the number where we are most likely to reach you.
Your answer
Please select the type of phone listed above (home, work, cell, etc) *
Parent/Guardian's Email Address
Your answer
Additional Parent/Guardian Information
Parent/Guardian #2 Full Name (First and Last)
Your answer
Parent/Guardian #2's relationship to the applicant
Your answer
Parent/Guardian #2's Street Address
If different than the one provided above
Your answer
Parent/Guardian #2's City of Residence
If different than the one provided above
Your answer
Parent/Guardian's State of Residence
If different than the one provided above
Your answer
Parent/Guardian's Zip Code
If different than the one provided above
Your answer
Parent/Guardian #2 Phone Number
Please list the number where we are most likely to reach you.
Your answer
Please select the type of phone listed above (home, work, cell, etc)
Parent/Guardian's Email Address
Your answer
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