STEP Proyecto Access Program Application
Applying For: *
Today's Date: *
MM
/
DD
/
YYYY
Student Name: *
Gender: *
Date of Birth:
MM
/
DD
/
YYYY
Student's Race/Ethnicity *
*Non-Minority must bring proof of low-income status to A-126
Required
Current Grade Level 2018 *
Required
School Name *
School ID #
Report Card
Scan and upload, or please bring into the Proyecto Access Office A-126
GPA *
Home Address *
Street, City, State, Zip Code
Phone #
Does the student qualify for Free Lunch?
Proof Required
How did you first hear about the STEP Proyecto Access Program? *
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