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Elevate Application I

Elevate 2017 Application I

Please fill out this application to be considered for Elevate 2017. *Note: This session may time out if you take more than 15 minutes to complete the form. If necessary, write your short response answers in another document and copy and paste your responses in before submitting your application.

1. Invitation Code (4 characters long, mixed letters and numbers):

2. First Name

3. Middle Name

4. Last Name

5. Preferred First Name

6. Gender

Male
Female

7. Date of birth (month/day/year)

8. What school do you attend?

9. What year will you graduate?

2018
2019

10. What is your current grade point average (GPA) on a 4-point scale?

11. Home Phone Number

12. Cell Phone Number

13. Email Address

14. Parent's or Guardian's First Name(s)

15. Parent's or Guardian's Last Name(s):

16. Parent's or Guardian's Email Address

17. Address line 1

18. Address line 2

19. City

20. State/Province

21. ZIP/Postal Code

22. Country

23. T-shirt size (men's sizes)

24. Are you a U.S. Citizen?

Yes
No

25. Would you like to identify yourself as Hispanic or Latino/a ? (optional)

Yes
No
Prefer not to say

26. If you wish to be identified with a particular ethnic group, please select the option that most accurately describes your heritage. No information you provide will be used in a discriminatory manner. (optional)

American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White

27. What academic area are you primarily interested in?

28. What other academic area are you interested in?

29. What aspect of Elevate is of most interest to you?

30. How did you hear about Elevate?

31. Are you currently interested in attending Gordon College?

Yes
No
Maybe