Project Ready Intake Form Disclaimer*Attendance Policy: Through this program, students will be exposed to invaluable information that will propel them in their post-secondary plans. This includes, but is not limited to workshops and seminars, academic advising, federal financial aid assistance, access to test preparation and much more. Participants of Project Ready receive all services for free and we hope that you will take advantage of these services. In order to receive any benefits from Project Ready such as attending field trips and college tours and gain access to college application and SAT/ACT fee waivers for example, students will be responsible to adhering to the attendance policy. Please see below for more details. To ensure that you are in good standing with Project Ready, please adhere to the following: •Attend up to 50% of workshops in a given academic school year •Attend up to 50% of other Project Ready events in a given school year. Failure to maintain satisfactory attendance will result in the immediate loss of Project Ready Benefits and/or suspension from the program for the remainder of the academic year. Please direct all questions or concerns to Project Ready Coordinator, Ricky Pulley or Whitney Harris at (864)244-3862.Select OneYes, I agreeI have more questionsDate* MM slash DD slash YYYY Previously Enrolled in Project Ready:* Yes No Name:* First Middle Last Suffix Age:* Date of Birth:* MM slash DD slash YYYY Race/Ethnicity*Select OneAmerican IndianAsian AmericanBlack or African AmericanHispanic or LatinoWhiteHigh School* Grade:*Select One9th10th11th12thDo you have a diagnosed disability?*Select OneYesNoIf yes, explain* Mailing Address:* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Telephone Number:*Email Address:* Preferred Contact:*Select OneTelephoneEmailHave you taken the SAT/ACT*Select OneYesNoIf yes, what were your scores?*What colleges have you applied to?*Top colleges you would like to attend?*Do you speak another language?*Select OneYesNoIf yes, which langauage? What other UL programs previosly enrolled or currently enrolled in:*Type student name for electronic signature* This is to certify that: 1. I am aware of and approve this application. 2. The Information provided in this application is true and correct. Name of Parent/Guardian* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Telephone Number:*Race/Ethnicity*Select OneAmerican IndianAsian AmericanBlack or African AmericanHispanic or LatinoDo you speak another language?*Select OneYesNoIf yes, which langauage? Does the child reside in your home?*Select OneYesNoWhat is the highest level of education you have completed?*Select OneLess than High SchoolHigh School GraduateSome CollegeCollege Graduate (BS,BA)Some Graduate SchoolGraduate DegreePost graduate DegreeHousehold Income:*Select One$0-$21K$22K-$33K$34K-$44K$45K+My child struggles in certain academic subjects:*Select OneStrongly DisagreeDisagreeAgreeStrongly AgreeIn which subject(s) do you feel your child struggles?MathematicsEnglish/Language ArtsHistory/Social StudiesScienceForeign LanguageType parent name for electronic signature* This is to certify that: 1. I am aware of and approve this application. 2. The Information provided in this application is true and correct.
