Online Enrollment Application

1. Student Info 2. Trip / Ref Info 3. Questionnaire 4. Terms & App Fee 5. Review Details 6. Confirmation

Student Information

This is step 1 of 6. Please complete all steps to successfully submit your application. Fields marked with an * are required.



STUDENT INFORMATION
* Legal First Name
  Middle Name
* Last Name
Preferred Name
* Birth Date / /
* Country of Citizenship
* Sex Male Female
* Height
* Weight lbs
* T-Shirt Size Small Medium LargeExtra Large
* Student Preferred Email
  Student Alternate Email
* Student Cell Phone

Name and location of student's current school and course of study
* Current Grade

INFORMATION ON NEXT OF KIN
  Student's next of kin Parent(s) Other Non applicable
  Student can provide information for... Both Parents Mother Father
  If contact information can be provided for the student's Mother please enter it. If not, leave blank.
  If contact information can be provided for the student's Father please enter it. If not, leave blank.
 
Mother's Information   Father's Information
Title   Title
First Name   First Name
Last Name   Last Name
Email   Email
Home Phone   Home Phone
Cell Phone   Cell Phone
Other Phone   Other Phone
 
Title      
First Name      
Last Name      
Relationship
Email      
Home Phone      
Cell Phone      
Other Phone      
PRIMARY ADDRESS (Where we will send all informational mailings)
* Who's address is this? School Parent Home Other
* Address
* City
* State
* Zip/Postal Code
* Country
BILLING ADDRESS (Where we will send all invoices)
* Who's address is this? School Parent Home Other
Same address as above?
* Address
* City
* State
* Zip/Postal Code
* Country

 

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