Online Survey Software | Qualtrics Survey Solutions

Instructions: Start and complete the application in one sitting. Be sure to have all attachments ready to submit with application.

Essays
Transcripts
Most recent report card
Free or Reduced lunch letter (if applicable)

Please enter your name below.

First Name

Last Name

Mailing Address

Street Address Line 1

Street Address Line 2

City

State

Zipcode

Gender

Male
Female

Date Of Birth (MM/DD/YEAR)

Phone Number

Career Goal

High School

Year of Graduation

Tee- Shirt Size

Small
Medium
Large
XLarge

Email Address

Parent's Email address

Limited number of partial scholarships are available to applicants who are eligible for

the Federal free or reduced lunch program. Please upload a letter, on letterhead, from an official

at the school district or the letter you received stating that you are eligible for the free or reduced

lunch program. In order to qualify, your letter MUST accompany your application.

Information on your letter of recommendations

Name of Science Teacher

Name of Math Teacher

What are your future goals and plans? ( Write an Essay and attach the pdf file below. The name of file should be in the format "Lastname Firstname Essay1" )

Why does this program interest you and what are your expectations, if any? ( Write an Essay and attach the pdf file below. The name of file should be in the format "Lastname Firstname Essay2" )

Attach your Transcript below

Attach your most recent Report Card Below