Scholarships | Conyers, GA

Student form

DEKALB COUNTY STUDENTS FORM

Free Text

* Name

First

Last

* Job Expo You Plan To Attend

* Email

Phone:

Date of Birth MM/DD/YYYY

Age

Gender

Mailing Address

City

State

Zip

Ethnicity

Are You a U.S. Citizen or Legal Resident (not required)

Current School Name:

Current School City

Current School State

School Counselor Name:

Current Grade Level

High School Graduation Year

Year You Plan to Enter College

GPA (4.0 Scale)

ACT (if available)

What Would You Like to Study in College (option 1)

What Would You Like to Study in College (option 2)

SAT (if available)

Parent/Guardian Name

* Parent Email (1)

* Parent Email (2)

Did One or Both Parent(s) Go to College?

Opt-In

I do hereby consent and agree that The Leadership Team (TLTUSA) has permission to provide my registration information to interested employers, colleges, universities, scholarship programs, sponsors, and service programs participating in the TLTUSA Job Fairs.

I further consent that my name may be revealed in descriptive text, captions, articles, or commentary. I understand that there will be no financial or other remuneration for registering, either for initial or subsequent transmission or playback.

Phone: 470-990-1692| Email: info@tltusa.org | Address: 2182 Salem Rd SE, Conyers, GA 30013

Phone: 470-990-1692

Email: courtneydillard.leader@gmail.com

Address: 2182 Salem Rd SE, Conyers, GA 30013