Summer 2019 College In High School Registration
Fill out this form to apply for the 2019 College in High School Program.
Student First Name *
Your answer
Student Last Name *
Your answer
Student Date of Birth *
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Student Sex *
Student Cell Phone *
Your answer
Student Email *
Your answer
Have you been in the program before? *
If yes, please state the school, summer, and course taken (example: CCAC, summer 2018, English 101).
Your answer
Intended College Major *
Your answer
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Parent/Guardian Phone *
Your answer
Parent/Guardian Email *
Your answer
Mailing Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Current High School *
Your answer
Grade *
If you're a senior, what college/university do you intend on attending in Fall 2019?
Cumulative GPA *
Your answer
Are you available Monday-Friday from 9AM-3PM between June 10, 2019- August 2, 2019? *
If no, please explain why.
Your answer
What course(s) are you interested in taking? *
Required
How did you hear about the Neighborhood Learning Alliance College in High School Program? *
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