UREC Academy 2023 General Interest Form
UREC Academy offers after school and summer initiatives to high school students throughout the year free of charge. The institutes prepare students for college, careers in law, healthcare and technology, entrepreneurship, and ACT preparation. Please select which upcoming institute(s) you or your child may be interested in participating in. Please note that is a general interest form, and additional information will be required during the application phase. 
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Please indicate which institute(s) you or your child may be interested in. Select all that apply. Please note that program dates are subject to change. *
First Name (Student) *
Last Name (Student) *
Student's Email *
Student's Phone
Student's School *
Student's Grade Level *
Student's Phone Current  Grade Point Average *
Parent/Guardian's First Name  *
Parent/Guardian's Last Name  *
Parent/Guardian's Last Email *
Parent/Guardian's Last Phone *
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