APPLY FOR ASSISTANCE

First Name

Last Name

Email Address

Address

Home Phone

Cell Phone

Parent/Guardian Names (Mandatory for applicants under 18)

Parent/Guardian Address (Mandatory for applicants under 18)

Parent/Guardian Emails (Mandatory for applicants under 18)

Who do you reside with if different from above?

Do you qualify for free, reduced lunch, or fee waiver programs? Do you qualify for free, reduced lunch, or fee waiver programs? Yes No I don't know

Are you from a single parent, low income, or Foster Care Household? Are you from a single parent, low income, or Foster Care Household? Yes No I don't know

Number of siblings/dependents in your household

Number of people in household enrolled in college (F/T or P/T)

Have you applied to any colleges, EOP, or other college programs? Have you applied to any colleges, EOP, or other college programs? Yes No

Have you applied for financial aid? (FAFSA/EFC/Cal Grant/CSS Profile) Have you applied for financial aid? (FAFSA/EFC/Cal Grant/CSS Profile) Yes No

Please tell us about any leadership/community volunteer work.

Please tell us what college you'd like to attend.

Current School Name and Location

Current Grade Level or Units Status

Current GPA (transcript required to confirm)

SAT/ACT Test Scores and Dates

Graduation or Transfer Year (expected)

Do you have a high school diploma or GED? Do you have a high school diploma or GED? Yes No Currently enrolled

Four-year college core course eligible? Four-year college core course eligible? Yes No I don't know

Academic Counselor Name (If applicable)

What is your primary sport?

Varsity, JV or F/S and Number of Years

Positions / Events

Are you a starter? Are you a starter? Yes No

Highlights video and best stats/marks available? Highlights video and best stats/marks available? Yes No

Coach Name

Do you have a secondary sport?

Varsity, JV or F/S and Number of Years

Positions / Events

Are you a starter? Are you a starter? Yes No

Highlights video and best stats/marks available? Highlights video and best stats/marks available? Yes No

Coach Name

NCAA ID Number

Have you had any contact from college coaches? Have you had any contact from college coaches?YesNo