BUDS Summer College Tour | Registration Form

BUDS Summer College Tour 2018

Student Registration Form
Student Information
Student Name *

First Name Last Name
Date of Birth *
(ex. MM/DD/YYYY)
E-mail *
Mobile Phone Number *

Area Code Phone Number
Home Phone Number

Area Code Phone Number
Emergency Contact Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
T-Shirt Size

Small Medium Large X-Large XXL
High School Name *
High School Year *

Freshman Sophomore Junior Senior
High School GPA
Primary Parent/Guardian Information
Primary Parent Name *

First Name Last Name
Primary Parent Email *
example@example.com
Primary Parent Mobile Number *

Area Code Phone Number
Highest Level of Education Completed *
Secondary Parent/Guardian Information
Secondary Parent Name

First Name Last Name
Secondary Parent Email
example@example.com
Secondary Parent Mobile Number

Area Code Phone Number
Highest Level of Education Completed

Student Profile Questionnaire
What school sports/activities are you involved in?
Do you participate in any activities outside of school? If so, please list them
What colleges are you interested in attending?
What colleges have you already visited?
What areas of study are you interested in?
(ex. Major/Minor, Undecided, etc.)
Have you taken the ACT/SAT? *

Yes No
If so, what was your highest score?
What topics do you wish to learn more about?

College Applications/Admissions Financial Aid/ Scholarships ACT Preparation College Essay Help Researching Schools
Do you have any dietary restrictions? If so, please list them.

Registration Fee

Registration Fee (Required) $ 20.00

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Total $ 0.00

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