Please complete all sections. Thank you.

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* 1. Student Last Name:

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* 2. Student First Name

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* 4. I will be the first person in my family to attend college.

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* 6. Current School

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* 8. Semester Grades 2017

  A B C D F N/A
ELA/READING
MATH 
SCIENCE 
SOCIAL STUDIES 

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* 9. CURRENT FSA LEVEL SCORES

  LEVEL 5 LEVEL 4 LEVEL 3 LEVEL 2 LEVEL 1 N/A
READING
MATH

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* 10. Contact Information

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* 11. Short Essay: Tell us what qualities you will demonstrate to be a successful student in our A.V.I.D. Program.

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