College Transfer Scholarship Registration - April 29th in Dobson

To enter the scholarship drawing and register for the event, please answer all the questions below. Be sure to hit submit when you are finished.

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* 1. First Name

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* 2. Last Name

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* 3. Please sign up for a time to hear a College Transfer Info Session Monday, April 29, 2019, on the Dobson campus. You will learn how classes transfer from Surry Community College to a four-year school along with helpful tips on college application and financial aid. High school juniors and seniors will learn about dual enrollment opportunties called Career & College Promise.

4 to 4:30 p.m.

5 to 5:30 p.m.

6 to 6:30 p.m.

I do not want to attend a session.

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* 4. Please provide your contact information.

Mailing Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

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* 5. What is your date of birth? Please enter month, day, year.
Example: 08/13/75

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* 6. If you are you a high school student, what is your current grade level?

9th

10th

11th

12th

I am not a high school student.

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* 7. Which programs are you considering? Please select all that apply.

Associate in Arts

Associate in Science

Associate in Fine Arts in Visual Arts

Early Childhood Education

Criminal Justice Technology

Criminal Justice Technology - Forensic Science

Nursing - RIBN Collaborative

Nursing - LPN-RIBN Collaborative

Spanish Language

Spanish Interpereter - Community and Medical Certificates

Undecided

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* 8. How did you hear about the College Transfer Open House? Please check all that apply.

Word of mouth (family member, friend or teacher told me)

Television advertisement

Social Media (Facebook, Instagram, YouTube, Twitter, LinkedIn)

Advertisement on my phone or computer

Flyer or brochure

Newspaper

Radio

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* 9. Enter today's date.

Date / Time

Date

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* 1. First Name

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* 2. Last Name

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* 4. Please provide your contact information.

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* 5. What is your date of birth? Please enter month, day, year. Example: 08/13/75

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* 6. If you are you a high school student, what is your current grade level?

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* 7. Which programs are you considering? Please select all that apply.

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* 8. How did you hear about the College Transfer Open House? Please check all that apply.

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* 9. Enter today's date.

* 5. What is your date of birth? Please enter month, day, year.
Example: 08/13/75