CAMPUS Application All information is confidential and will only be shared with counselors and the selection committee Name: Middle Initial Last Middle School: High School: Current Grade Level: Home Address: Phone: Email: City: State: Zip: Date of Sex: M F With which ethnic group do you identify: Asian African American Hispanic Optional: Native American Caucasian Other Family Information Mother/Guardian Name: Father/Guardian Name: Occupation: Occupation: Employer: Employer: Home Phone Cell Phone: Home Phone: Cell Phone: Email: Email: Highest Level of Education: (USA or Abroad) Highest Level of Education: (USA or Abroad) years in high school years in high school High school diploma High school diploma GED GED 2-Yr. college diploma (AA) 2-Yr. college diploma (AA) 4-Yr. college diploma (BS/BA) 4-Yr. college diploma (BS/BA) Degrees beyond BS/BA or Degrees beyond BS/BA or Certifications Certifications Degrees Earned outside US (School Attended) Degrees Earned outside US (School Attended) Optional: Is your child eligible for free or reduced school lunch? Yes No Does your family receive public assistance? Yes No Does your family reside in federally subsidized housing? Yes No Please list any languages other than English spoken at home:
CAMPUS Application All information is confidential and will only be shared with counselors and the selection committee Name: Middle Initial Last Middle School: High School: Current Grade Level: Home Address: Phone: Email: City: State: Zip: Date of Sex: M F Optional: With which ethnic group do you identify: Asian African American Hispanic Native American Caucasian Other Family Information Mother/Guardian Name: Father/Guardian Name: Occupation: Occupation: Employer: Employer: Home Phone Cell Phone: Home Phone: Cell Phone: Email: Email: Highest Level of Education: (USA or Abroad) Highest Level of Education: (USA or Abroad) years in high school years in high school High school diploma High school diploma GED GED 2-Yr. college diploma (AA) 2-Yr. college diploma (AA) 4-Yr. college diploma (BS/BA) 4-Yr. college diploma (BS/BA) Degrees beyond BS/BA or Degrees beyond BS/BA or Certifications Certifications Degrees Earned outside US (School Attended) Degrees Earned outside US (School Attended) Optional: Is your child eligible for free or reduced school lunch? Yes No Does your family receive public assistance? Yes No Does your family reside in federally subsidized housing? Yes No Please list any languages other than English spoken at home:
2017-18_English_CAMPUS_Upperclassmen_Application.docx