Lehigh University Diversity Achievers Program (DAP) Application

11% of survey complete.

First (Given) Name:

Middle Name:

Last Name (Surname):

Address: *

Address 2:

City/Town: *

ZIP/Postal Code: *

State: *

Home Phone Number (XXX-XXX-XXXX): *

Cell Phone Number (if none, please type N/A): *

Female

Male

African, African-American, Black

Asian, Indian

Hawaiian, Pacific Islander

Hispanic, Latino

Multi-racial

Native American

White

Other (please specify)