Summer 2025 Jump Start HBCU College Tour Registration

2025 Jump Start HBCU College Experience (Registration Form)

Join us for the Jump Start Summer College Experience
June 1-6, 2025

$550/student ($50 non-refundable deposit due now with registration) - Includes 3 meals except travel day, chartered transportation and hotel accommodations (double occupancy). Note: Departure date may be adjusted to June 2.
Proposed Itinerary

South Carolina State and Claflin University (Orangeburg) (Or Benedict based on school schedule), Johnson C. Smith (Charlotte), North Carolina A&T and National Civil Rights Museum (Greensboro), North Carolina Central University (Durham), Winston-Salem State (Winston-Salem) and historical sites schedule permitting.
Student Name*

First NameLast Name
Student Phone Number*
Please enter a valid phone number.
Student Email*
example@example.com
Student Gender*
Current School Name*
Current Student Classification*
How did you learn about our program?*
Student Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Phone Number*
Please enter a valid phone number.
Parent/Guardian Email*
example@example.com
Secondary Parent/Guardian Name

First NameLast Name
Secondary Parent/Guardian Phone Number
Please enter a valid phone number.
Secondary Parent/Guardian Email
example@example.com
Please upload a headshot photo of yourself with a plain, neutral background.*

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Please share your reasons for wanting to attend the Summer tour in at least FOUR to FIVE sentences. Emphasize what you hope to gain from this experience and how it relates to your future college plans or career development. *
By submitting the deposit, I acknowledge the following statement below.
To meet our contractual obligations without penalty, we need strict adherence to this schedule to avoid canceling the trip. First come-first served. Space is limited to 40 students. I have read and understand the goals.*

I Agree
I understand The College Navigation and Leadership Sessions are open to ALL students who want to gain knowledge, tools and resources to navigate to a career, including leading to college. I understand I can attend ALL 10 sessions offered, even if I am not going on a tour. You can register for each session when scheduled offered March – December.*

I Agree
To join the tour, I understand I must attend at least three College Navigation and Leadership Sessions, at least one Teen Socratic Circle, and a final team building session before we depart!*

I Agree
There will be a separate application for the June and October tours with a $50.00 non-refundable deposit when the application window opens. The deposit will help defray the cost of snacks, driver gratuity, and other incidents. The deposit holds your space if payment schedule is met, all required forms are submitted on time.

Payment Schedule:
Installment 1 - Due 3/30/2025 - $183.33
Installment 2 - Due 04/30/2025 - $183.33
Installment 3 – Due 05/15/2025 - $183.34

Registration Deposit*

2025 Jumpstart Summer College Tour DepositNon-Refundable Deposit for ONE Student

$50.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

I hereby grant permission to the Gaddis Foundation to use photographs and/or video recordings of my child for educational and promotional purposes. This permission includes the use of such materials in print, electronic, and digital media, including but not limited to websites, social media platforms, newsletters, brochures, and presentations.*

I agree
Please Note:

Additional mandatory forms, i.e., permission and medical forms, will be required later. Thank you!
Invoice ID
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2025 Jump Start HBCU College Experience (Registration Form)

June 1-6, 2025

Proposed Itinerary

Please Note: