Name of Applicant_______________________________________

Female: M
F

Male or

Address:
______________________________________________________________________
City/Zip:
______________________________________________________________________
Parent/Guardian Name:
__________________________________________________________
Parent/Guardian Email:
__________________________________________________________
Student Email:
_________________________________________________________________
Work Phone: ______________________________ Home
Phone:________________________
Student Cell Phone:_________________________ Parent Cell:
__________________________
Please write in how you identify (ethnically/racially)
__________________________________
School Information
High School:______________________________________ Grade Level:___________
City:_____________________________________________
Guidance Counselor:_______________________________________________________
Guidance Counselor Email:__________________________________________________
Semester GPA:________________________ Cumulative GPA:____________________
Colleges Considering:
_________________________________________________________
Majors Considering:
___________________________________________________________
Will you be a First Generation College Student (meaning will you be the first
person in your family to attend college and graduate?) Circle the one that
applies to you: YES NO

Parent(s) Annual Income______________________

Please Check one: Single Parent Household_________ Two Parent Household:
_________
Number of Dependents: ___________

I verify all information in the enclosed application to be true:

____________________________
(Signature
of Applicant)
I am aware that my child is applying for this tour:
____________________________________
(Signature of
Parent/Guardian)