Section 1: Personal Information
Name *
Name
Date of Birth *
Date of Birth
City and Country
Are you a U.S. Citizen or Legal Permanent Resident *
Home Address *
Home Address
Home Phone
Home Phone
Cell Phone *
Cell Phone
Student lives with (check all that apply) *
Parent/Guardian 1 Name *
Parent/Guardian 1 Name
Work Phone
Work Phone
Cell Phone *
Cell Phone
Is this parent/guardian disabled? *
Was this parent born in the U.S? *
Home Address *
Home Address
Parent/Guardian 2 Name *
Parent/Guardian 2 Name
Work Phone
Work Phone
Cell Phone *
Cell Phone
Is this parent/guardian disabled? *
Was this parent born in the U.S? *
Home Address
Home Address
Section 2: Academics
Section 3: Personal Interest
Section 4: Career & Technical Interests
Section 5: Student Essay
Please answer the following questions in 350-500 words
Section 6: Parent Essay
Please answer the following question in one paragraph
Section 7: Letters of recommendation
Please provide information for a teacher or counselor we can contact for a letter of recommendation. You should also notify them that you gave us their information
Name *
Name
Phone *
Phone
Section 8: Financial Information
Do you receive free or reduced lunch? *
Section 9: Electronic Signature
I certify that the information provided in this application is complete and accurate to the best of my knowledge. Falsification of any information will cause disqualification from the program. Acceptance of the program's membership constitutes permission to use the recipient's name and/or likeness for public relations purposes.
Today's Date *
Today's Date