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Student Information

First Name: Last Name:
Student ID Number:
(If unknown, please input TBD)
Date of Birth:
Email Address: Phone Number:
Address: Address2:
City: State:
Zip Code:




High School:

Grade Level:

If so, what company?

Will you have a cumulative 2.5 GPA by March 2020?

Please enter your GPA in the ONE appropriate box below.

Most Current Cumulative End-of-Year GPA: (100 Point Scale)

Are you in AVID ?

Are you in CTE program ?

If you go to college, will you be the first in your family to attend ?