Up and Coming Scholars Application

Student Name and Contact Information

FIRST Name

Middle Name

LAST Name

Birthdate

Mobile Number

###-###-####

Do you want to receive text messages from Angelo State? (Standard message and data rates may apply.)

YesNo

Student's Personal Email Address

This must be the student's email address. Please DO NOT enter the parent's email address here. There will be a place for parent email in another section of this application. It is important that we be able to communicate directly with the student. Please DO NOT use your school-assigned email address.

Mailing Street Address

City

State

Zip Code

School

When do you expect to graduate high school?

It is VERY important to select the correct year you will be graduating!

Are you Hispanic or Latino?

YesNo

Ethnicity

Parent Information

Parent First Name

Parent Last Name

Parent Phone Number

Parent Email Address

Would your parent/guardian prefer to receive emails and other communications in Spanish?

YesNo

Consent

Statement of Understanding

My parent or guardian is aware of my intent to join the Up and Coming Scholars Program and supports this decision.

I understand that I also must complete and sign the required consent forms in order for my application to be considered complete. If the required waivers as outlined in the letter are not submitted before the application deadline, I understand I will not be considered for the Up & Coming Scholars program.

Yes, I understand and will complete, sign, and submit the necessary forms. I understand that the required forms MUST be submitted in order for my application to be considered complete.

I understand that I must attend the majority of the events in order to qualify for an honor card at graduation.

Yes, I acknowledge that I must attend the majority of the events in order to qualify for an honor cord at graduation.

Why do you want to be in the Up & Coming Scholars Program?