Girls & Boys With A Purpose College Fair Students' Registration Form
Girls & Boys With A Purpose College Fair | 7th September 2024 - 10:30am - 1:30pm | Ike Owings Community Center, 8830 Gurley Road Douglasville, GA 30134 | giavani@thrive-usa.org | 404-643-3100 | @thriveusainc
Personal Information
Name
*
First Name
Last Name
Gender
Please Select
Male
Female
Prefer not to say
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Academic Information
Current School Name
*
Current School Grade
Please Select
Freshmen
Sophomore
Junior
Senior
Intended Major/Field of Interest
Event Information
How did you hear about the Girls & Boys With A Purpose College Fair?
*
School Counselor
Teacher
Friend/Family
Social Media
Website
Other
Are you interested in meeting with any specific colleges or universities? If so, please list them below:
Do you have any special requirements or accommodations?
Yes
No
If yes, please specify below.
Parental/Guardian Information
(If under 18 years of age)
Parent/Guardian Name
First Name
Last Name
Parent/Guardian Contact Number
Please enter a valid phone number.
Parent/Guardian Email
example@example.com
Emergency Contact Information
Emergency Contact Name
First Name
Last Name
Emergency Contact Relationship
Emergency Contact Number
Please enter a valid phone number.
Signature
By signing below, I confirm that the information provided is accurate and complete to the best of my knowledge. I understand that my participation in the college fair is voluntary.
Student Signature
Date
-
Month
-
Day
Year
Date
Parent/Guardian Signature
If under 18 years of age.
Signature
Date
-
Month
-
Day
Year
Date
Thank you!
We look forward to seeing you at the Girls and Boys With A Purpose College Fair.
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