2021 Fall Student Workshop Registration

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Welcome to join us. Please help us by answering the following questions.

Your legal name (For Scholarship Purpose)? *

Your preferred name? *

Date of Birth *

YYYY

Gender *

Female

Male

Email Address *

Phone number *

What school will you be attending this FALL? *

Are you a full time student now? How many classes you are taking? How many units ? *

What is your major? (If in high school, what is your grade level) *

What is your minor? *

What are some of your strengths or talents that could be beneficial to the program? *

Would you be interested in helping to organize the workshops? *

Yes

Other:

Do you have any questions, comments, or concerns about this college student workshop? *

How did you know about this program? *

Submit

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