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Last |
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Address |
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Street Address |
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City |
State |
Zip |
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Cell Phone #:
Birthday Information is used to create your unique accountname:
Birth Month
Birth Date
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Do you qualify for Free & Reduced Lunch?
Yes
No
Unknown
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Student E-Mail*1 is required*:
RETYPE E-Mail:
Personal E-Mail*1 is required*:
RETYPE Personal E-Mail:
** Your personal e-mail address is preferred provided you check it often.
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Gender:
Male
Female
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Select Your High School:
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Grade During 2021-2022 School Year:
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PRE-COLLEGE PROGRAM ALREADY ATTENDED (any Upward Bound, Talent Search,
or other academic program you may have attended)
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Partner UB/ETS Programs:
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Other Program Name: |
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Dates Attended (from - - - to) |
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Host Institution |
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Your Essay:
You may type this essay in Word or Google Drive, then copy and paste your
answers into this online form. Your essay should fully answer the two questions
below, use correct grammar and spelling, and be written professionally (use of
the first person—I, me, etc.—is acceptable). We use this essay to get a
glimpse of who you are as a person, so use your own voice and express yourself!
- In your own words, tell us why you want to attend the Regional Center for Math and Science.
- Describe your future educational plans and any career(s) you are interested in.
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A 500 character minimum is Required to submit online!
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