Bison Mentoring 2023-2024 Session Student Application
HOWARD UNIVERSITY ALUMNI CLUB OF ATLANTA
Name
First Name
Last Name
Gender
Male
Female
Email
example@example.com
Phone Number
Please enter a valid phone number.
High School
Grade
I'm interested in majoring in:
My career goal is:
Extra curricular activities and interest:
Back
Next
Parent's Name
First Name
Last Name
Parent's Email
example@example.com
Parent's Phone
Please enter a valid phone number.
Parent's Name #2 (optional)
First Name
Last Name
Parent's Phone #2 (optional)
Please enter a valid phone number.
Parent's Email #2 (optional)
example@example.com
Student Headshot Photo (alternatively, email appropriate pic to huacamentoring@gmail.com with Subject: Mentoring Pic - your name)
Submit
Should be Empty: