Xploration Tour Registration Form

WHD Student Advocacy Group

Xploration Tour Student Application
Student Last Name:
Student First Name:
Email
example@example.com
Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState

Zip Code
Parent/Guardian Last Name:
Parent/Guardian First Name:
Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address (if different from student)

Street Address Line 2

CityState

Zip Code
If Parent/Guardian would like to chaperone check box
School Name:
Current or Last Attended
Current GPA:
Current Grade Level:
How did you hear about us?
Tell us a little more about yourself
Why do you think college tours are important.:

0/200
My career goal is:

Tell us what motivates you.0/40
_Hello,

_{Thank you for your interest in experiencing WHD Xploration Tours! We are proud to be celebrating our 14th year bringing students to the most amazing college campuses. You should hear from us 2-3 business days after submitting your Interest Form for an interview. Tours fill up fast as our scholars have priority. During the interview we hope to learn about you, answer any questions, i.e. costs, availability, etc, and give you the opportunity to learn more about the Foundation and our work.}

_{Looking forward to being your host.}

The information contained in this document is confidential. It is intended solely for the use of the individual(s) or organization(s) to whom it is addressed. Any disclosure, copying or further distribution is not permitted unless such privilege is explicitly granted writing by The William H. Douglas Foundation

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WHD Student Advocacy Group

Tell us a little more about yourself