Xploration Tour Registration Form

William H. Douglas Foundation

Xploration Tour Student Application
Student Last Name:
Student First Name:
Email
example@example.com
Cell Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState

Zip Code
Parent/Guardian Last Name:
Parent/Guardian First Name:
Cell Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address (if different from student)

Street Address Line 2

CityState

Zip Code
If Parent/Guardian would like to chaperone check box

yes
School Name:
Current or Last Attended
Current GPA:
Current Grade Level:

FreshmanSophomoreJuniorSenior
How did you hear about us?*
Tell us a little more about yourself
Favorite Subject:

0/200
I am most excited about:

Tell us what motivates you.0/40
_Hello,

_{Thank you for your interest in experiencing WHD Xploration Tours! We are proud to be celebrating 12 years bringing prospective students to the most amazing college campuses. Once you have submited your form, a WHD Advocate will contact you for an interview by February 5th. All questions will be answered during the interview.}

_{Looking forward to being your host.}

The information contained in this document is confidential. It is intended solely for the use of the individual(s) or organization(s) to whom it is addressed. Any disclosure, copying or further distribution is not permitted unless such privilege is explicitly granted writing by The William H. Douglas Foundation

Copyright© 2012-2025 William H. Douglas Foundation
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William H. Douglas Foundation

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