Young Scholar Registration Form

    Birthdate
    Birthdate
    Gender
    Gender
    Ethnic background (please check only one)
    Are you Hispanic or Latino?
    Ethnic background (please check only one)
    Are you Hispanic or Latino?
    What is your racial background? (please check one or more)
    What is your racial background? (please check one or more)
    Mailing Address
    Mailing Address
    Please list the courses you wish to take this semester as well as alternate courses. In the event that we cannot register you for your first choice, we will try to register you for your alternate choices. Thank you.
    Please list up to (3) alternates.