2025 Fall Registration Form PWY HBCU Tour

2025 Student Registration Form

Fill out the form carefully for registration
Student Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student E-mail*
example@example.com
Student Mobile Number*
Name of current High School *
Current Grade Level*
Anticipated Collegiate Major*
Which HBCUs are you most interested in visiting during the PWY tour? *
Parent/Guardian Name*
Parent/Guardian Cell Phone Number*
Parent/Guardian Email*
example@example.com
How were you referred to the PWY HBCU Tour event?*
Please write full name
HBCU Signature Tshirt

All students will recieve a special HBCU t-shirt. Please be sure to select your size. No t-shirts can be exchanged.T-shirts are standard unisex cotton shirts.
Unisex Tshirt Size*

SmallMediumLargeX-LargeXX-Large
Payment $1000

For CashApp($PetiteAffairs)

https://cash.app/$PetiteAffairs

For Zelle (7328011448)

For other payment options please contact PWY.

PAYMENT

USD

2025 Student Registration Form