STARTALK 2019 Summer Language Program at Hunter College Application Form
Last Name *
First Name *
Chinese Name
(If applicable)
Do you have a social security number *
Date of Birth (Month/Date/Year) *
Sex *
Required
Permanent Address *
(Please include city, state, and zip code)
Telephone Number (Day) *
Telephone Number (Eve) *
Email Address *
Name of Your School *
Grade Level *
(Spring 2019)
GPA *
SAT/PSAT score
(If applicable)
U.S. Citizen? *
NY State Resident *
Parent/Guardian Name (A) *
Relation to Applicant *
Telephone Number *
Email Address
Parent/Guardian Name (B)
Relation to Applicant
Telephone Number
Email Address
Person to Contact in Case of Emergency (A) *
(Other than parents)
Relation to the Applicant *
Telephone Number *
Person to Contact in Case of Emergency (B) *
(Other than parents)
Relation to the Applicant *
Telephone Number *
Applicant Signature *
(Please type name)
Date *
Parent/Guardian Signature *
(Please type name)
Date *
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