CBPUSD PROGRAM ROSTER
Email address *
SCHOLAR SECTION
New or Returning Scholar to the program
Scholar School ID# *
If you do not know the correct number, please input 99999
Your answer
Scholar Last Name *
Your answer
Scholar First Name *
Your answer
Gender of Scholar *
District *
School
Grade
Scholar Email
Your answer
Scholar Cell
Format (xxx)xxx-xxxx
Your answer
Street Address
Your answer
City, State, Zip
Your answer
Scholar T-Shirt Size
Scholar Race/Ethnicity
Check all boxes that apply
Check all that apply
American Indian
Asian
Black/African American
Caucasian
Filipino
Hispanic
Decline to State
GPA Previous School Year
Your answer
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