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CollegePATH, Inc.,PO BOX 243333,Boynton Beach, FL 33424-3333
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All Fields marked with
*
are mandatory.
SECTION I: Student/Parent Info:
*
Student First Name:
*
Student Last Name:
My friends call me:
Gender:
Male
Female
*
Date of Birth:
Mailing Address:
*
Street Address:
*
City:
*
State:
Zipcode:
Occupation:
*
Home Phone:
Cell Phone:
*
Email:
Social Media Presence:
Facebook:
Twitter:
Instagram:
Other:
Parent/Guardian I:
*
Parent Name:
*
Relationship:
Mailing Address:
*
Street Address:
*
City:
*
State:
Zipcode:
Occupation:
*
Home Phone:
Cell Phone:
*
Email:
Parent/Guardian II:
Guardian Name:
Relationship:
Mailing Address:
Street Address:
City:
State:
Zipcode:
Occupation:
Home Phone:
Cell Phone:
Email:
BEST PARENT/GUARDIAN TO CONTACT:
Name:
SIBLINGS:
Name:
Age:
Name:
Age:
Name:
Age:
Name:
Age:
SECTION II: Education:
Current Grade LEVEL:
Expected Graduation Year:
Current High School:
Previous High School:
GPA:
/
Cumulative
GPA:
/
Weighted
Class Rank:
ACT:
ACT Score(s):
English ACT Score(s):
Math ACT Score(s):
Reading ACT Score(s):
Science ACT Score(s):
SAT:
SAT Score(s):
PSAT:
Math SAT Score(s):
Critical Reading SAT Score(s):
Verbal SAT Score(s):
Did you take an SAT subject Test?
Y or N
If yes, please put subject and score below:
Yes
No
SAT Subject Test(s):
SAT Subject Test(s):
What assistance do you need from CollegePATH?
Please indicate how you learned about CollegePATH
Student Questionnaire:
Extracurricular Involvement:
Please indicate your involvement in school and community activities including any leadership positions held and work experience during the past two years (if applicable).
General Information:
Of the activities that you listed, which one(s) do you enjoy the most? Why?
What do you consider to be your greatest strength(s) and why?
What do you consider to be a weakness that you would like to change into a strength?
What do you hope to learn throughout this process?
*
Applicant’s Signature:
*
Date:
*
Parent/Guardian’s Name:
*
Parent/Guardian’s Signature:
*
Date:
Parent/Guardian’s Name:
Parent/Guardian’s Signature:
Date:
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