HBCU Night Registration

Scholar Success Story Registration Form.

Please fill out the form carefully
Your Name:

First NameMiddle InitialLast Name
Are you interested in an HBCU Night #DecisionDay Success Story Spotlight and potential article coverage of your success story?:
Birth Date:

DayMonthYear
Gender:
Are you at least 14 years old or older? (If not, parents must attend with you):
Age:
E-mail to share with recruiters:
example@example.com
Phone Number to share with recruiters:
Please enter a valid phone number.Format: 0000000000.
Hometown/City, State:
HBCU I am committ(ing)(ed) to:
Total # of College Acceptances:
Total Dollar Amount in Scholarships Offered:
I.e., $809,728
Two-sentence Quote on how HBCU Night has helped you learn about HBCUs and to contributed to your decision-making process:
Current High School or Community College:
High School or Community College Graduation Class:
HBCU Graduation Class:
Classification:
Grade Point Average (GPA from final semester/marking period going into Summer '21):
Test Score:
Test Type:
Instagram Handle (@ on social media):
Twitter Handle (@ on social media):
List all HBCUs you are interested in applying to:
Extra Club/Organization/Curricular/Community/Leadership Experience to share with HBCU recruiters:
Why an HBCU?
What is your desired profession after you graduate college?
Areas of study you are interested in

Other
Interested in our Scholarship Talks Sessions/Scholarships:

Scholar Success Story Registration Form.