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Student Application Form
Address (please specify apartment # or floor if applicable, and zip code)
Select preferred location for pick up/drop off, if selected:
Mont Pleasant MS
Central Park MS
What class(es) do you enjoy most in school?
What do you like the most about Science? What do you like the least?
What do you like the most about Math? What do you like the least?
Do you like figuring things out/solving problems? If so, please tell us more.
What problems do you want to solve as an adult using your knowledge in science and math? Is there a profession that you have in mind? (It is ok if you are not sure yet.)
What interests you about Rise High?
What do you want to get out of the program?
Why do you think you are a good candidate for this program?
Do you understand that this is a commitment to a weekly program on Saturdays?
Do you understand that if selected, you will have the opportunity to continue growing and learning with the Rise High family and friends through high school?
PLEASE ASK A GUARDIAN/ADULT TO HELP YOU WITH THE NEXT QUESTIONS ON INDIVIDUAL AND FAMILY NEEDS (mark all that apply).
Number of people in the household (including applicant) and ages
Special circumstances that add to financial stress or limitation of resources (examples: single parent home, disabilities, elder dependents, health-related issues, unemployment/underemployment, limited family experience with college)
Lack of access to social/enrichment programs (examples: after school programs, community groups, youth groups, sports groups) Explain:
No access to mentors
Please expand on selections above or describe other limitations not listed.
Did your legal guardian(s) graduate from high school or have a GED equivalency certificate?
Explain (if needed):
Did you legal guardian(s) go to college?
Explain (if needed)
With what ethnic group do you identify yourself? (This is voluntary – the information provided will only be used for statistics purposes. Ethnicity is not a factor in our selection process).
Anything else that you would like to share with us to consider in your application?