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E-School For Girls 2022 Application
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Age
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Gender
*
Female
Other
Race/Ethnicity
*
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Other
Home Address
*
Your answer
City, State, and Zip Code
*
Your answer
Emergency Cell Phone Number
*
Your answer
Emergency Contact
*
Your answer
Emergency Contact Email
*
Your answer
Emergency Contact Phone Number
*
Your answer
Will you be a first generation college student?
*
Yes
No
Were you eligible to receive free or reduced cost lunch at your school?
*
Yes
No
Name of High School
*
Your answer
High School Address
*
Your answer
Current Grade
*
9th
10th
11th
12th
High School Guidance Counselor or College Advisor
*
Your answer
High School Guidance Counselor or College Advisor's email address
Your answer
GPA (100 point scale)
*
Your answer
PSAT/SAT Reading Score
*
Your answer
PSAT/SAT Math Score
Your answer
ACT Composite Score
Your answer
Extracurricular's (Clubs, Sports, Jobs, etc.)
*
Your answer
Short Answer: Please answer the following two questions in no more than 300 words. Please describe your career goals (
optional
)
Your answer
What do you hope to gain from attending our program (E-School for Girls)? (
optional
)
Your answer
How did you hear about us?
*
College Advisor/Guidance Counselor
Past Student
Online
Parent/Guardian/Relative/Friend
Other:
Signature (Type Name)
Your answer
Date Completed
*
MM
/
DD
/
YYYY
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