21.22 NiswongerCARE Enrollment
Sign in to Google to save your progress. Learn more
TERMS AND CONDITIONS
Thank you for taking the time to complete this form. Completing this will give us some valuable information as we assist you in planning for life after high school. By agreeing to the terms and conditions, you are granting NiswongerCARE permission to use your mobile/cell number to text helpful reminders and information specific to your postsecondary plan through Signal Vine. Your CARE advisor will also respond to messages from you should you have questions or need assistance. You may opt out of the program at any time by texting, "stop" or "cancel." *
Required
Tell us about you....
First Name (use the name you prefer to be called) *
Last Name *
Which high school do you attend? *
What grade are you in? *
Birth Date (so we can send you a Happy Birthday message!)
MM
/
DD
/
YYYY
Personal cell phone number *
Please type the phone number as a ten digit number with no parenthesis or dashes, example: 4234567891
Personal Email address (put N/A if you don't have one or choose not to share this information) *
What are your plans after high school? *
What college(s)/technical school(s) are you considering? *
Did either of your parents complete a college degree? *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Niswonger Foundation. Report Abuse