Bulldog Scholars Academy

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* 1. First Name:

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* 2. Last Name:

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* 3. Student ID #:

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* 4. Street Address:

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* 5. Street 2:

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* 6. City:

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* 7. State:

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* 8. Zip Code:

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* 9. Mobile Phone Number:

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* 10. Home Phone Number:

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* 11. Email Address:

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* 12. Gender:

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* 14. T-Shirt Size:
*Women who prefer a men's cut are welcome to select that option.

  Women's Men's
XS
S
M
L
XL
XXL
XXXL

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* 15. Extra-curricular Interests:

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* 16. Other Interests:

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* 17. Accommodations: 
In accordance with state and federal laws, Bowie State University provides reasonable accommodations for students with medical conditions and disabilities. If relevant, please disclose disability and housing needs. Disclosure will not impact eligibility for Bulldog Scholars Academy.

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* 18. Roommate Request:
We will consider roommate requests. To honor the request, the person you wish to room with must also request to room with you. 

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* 19. Parent/Guardian Name:

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* 20. Relationship to Student:

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* 21. Daytime Phone Number:

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* 22. Evening Phone Number:

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* 23. How did you hear about Bulldog Scholars Academy?

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