Register for the Presidential Scholarship Competition

First Name:	*	Last Name:	*
Gender:	Male Female *
Address:	*
City:	*
State:	*	ZIP Code:	*
Email:	*	Parent Email:
Telephone or Cell Number:	*
Academic Interest #1:	*
Academic Interest #2:
Varsity Sports Interest:
Extracurricular Interests:
T-shirt Size:
Overnight Stay:	With parent in hotel Stay on campus with host Stay on campus with friend
Name(s) of Parents Attending:	Parent 1: Parent 2: