HBCU Night (A DiGiTAL WORLD) Registration

A DiGiTAL WORLD Registration Form (Fall '22)

Please fill out the form carefully
Your Name:*

First NameMiddle InitialLast Name
Name of Parent/Guardian:*

First NameMiddle InitialLast Name
Birth Date:*

DayMonthYear
Gender:

MaleFemaleI choose not to share
Are you at least 14+ years of age? (If not, you will NOT be able to complete this form and a parent or guardian must email management@hbcunight.org separately to request attendance. Parent or guardian must be in attendance with any scholar under the age of 14):*

YesNo
Age:*
E-mail to share with recruiters:*
example@example.com
E-mail of Parent/Guardian:*
example@example.com
Phone Number to share with recruiters:*
Please enter a valid phone number.
Phone Number of Parent/Guardian:*
Please enter a valid phone number.
Hometown/City, State:*
Current High School or Community College:*
High School or Community College Graduation Class:*
Classification:*
Grade Point Average (GPA from most recent semester/marking period going into Fall '22):*
Test Score:
Test Type:
List all HBCUs you are interested in applying to:*
Extra Club/Organization/Curricular/Community/Leadership Experience to share with HBCU recruiters:*
Instagram Handle (@ on social media):
Twitter Handle (@ on social media):
Why an HBCU?
What is your desired profession after you graduate college?
Areas of study you are interested in*

Business, Economics, Commerce, Management, Finance, AccountingTechnology, EngineeringMathematics, Sciences, ComputerHumaities, Social Sciences, Communication, Literature / Language. History, African-American StudiesCulinary, Tourism, Leisure, HospitalityHealth Care, Psychology, Care ServicesFashion Design, Visual / Multimedia / Graphic Design, ArtsLaw, Politics, Public Administration, Public order and Safety, International Relation, Military, ROTCArchitecture, Building, Interior DesignAgriculture, EnvironmentOther
Are you interested in our Scholarship Talks Sessions/Scholarships?*

YesNo
Are you interested in a follow-up for our Scholarship Success Stories in May-June '23? (Scholar/Parent/Guardian must sign parent agreements to participate be featured in top media outlets)*

YesNo
Are you interested in a chance to win a laptop as a top HBCU Night Scholar?*

YesNo

A DiGiTAL WORLD Registration Form (Fall '22)