First Name:
Last Name:
Preferred Email Address
Personal
Alternate
Personal Email:
Alternate Email (for example, your parent's email):
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Primary Address Street:
City:
State:
Zip Code:
County:
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Preferred Phone Number Type
Home
Cell
Home Phone Number:
Cell Phone Number:
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Date of Birth:
High School Graduation Year:
GPA:
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Who do you currently live with?
Parent/Guardian Full Name:
Parent/Guardian Primary Phone Number:
Parent/Guardian Primary Alternate Phone Number:
Parent/Guardian Email:
Parent/Guardian Occupation:
2nd Parent/Guardian Full Name:
2nd Parent/Guardian Primary Phone Number:
2nd Parent/Guardian Alternate Phone Number:
2nd Parent/Guardian Email:
2nd Parent/Guardian Occupation:
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School Lunch Status
Free
Reduced
Full Price
Parent/Guardian Highest Education Level:
Pre-High School
Some High School
High School Diploma/GED Certificate/Associate's Degree Bachelor's Degree
Advanced Degree
Unknown
Identity:
Person of Color
Hispanic or Latino
Caucasian or White
Multiracial
Appalachian
International Citizen
Disabled
Lesbian/Gay/Bisexual/Transgender
1st or 2nd Generation Immigrant
Other
Other
Identity Note:
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I am...
in 7th grade and would like to apply for Camp New Beginnings.
in 8th-12th grade and would like to apply for Camp Steele.
in 7th-12th grade and CAN NOT attend camp this summer but would like to apply to High Rocks.
I am in:
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
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Why do you want to come to High Rocks? What is most exciting to you about it?
What do you think are your best qualities? Describe them. What would you like to change or work on about yourself?
Tell us about a dream you have for yourself.
What is something many people don't know about you and would be surprised to learn?
What is a change you would like to work towards in your school, community or world? Why?
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Write about a person who has inspired you and why. How has the example they have set helped change the way you live your life? (about 250-750 words)
If you are accepted to High Rocks and decide to attend, you will be asked to submit a letter about why you should have a scholarship to participate in High Rocks. Submitting a letter when you apply is optional, but we encourage you to do so for practice! (letter should be about 250-500 words)
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RECOMMENDATION FORM
You need to ask someone (no parents or relatives) to submit an online recommendation form for you. You can ask a teacher, coach, pastor, community leader, or another person who knows you well. Please list the NAME, RELATIONSHIP, and PHONE NUMBER of the person you plan to have complete this recommendation form for you that we can contact if we have questions.
Name:
Phone Number:
Relationship to you:
Submit
Should be Empty: