Please complete all sections. Thank you.

* 1. Student Last Name:

* 2. Student First Name

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

* 6. Current School

* 8. Semester Grades 2017

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

* 9. CURRENT FSA LEVEL SCORES

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

* 10. Contact Information

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

T