Success Boston - CLASS OF 2013
Background Information
Full Name
Male
Female
Please check all that apply
African American or Black
Asian
Caucasian
Latino or Hispanic
Native American
Native Hawaiian or Pacific Islander
Other
Please describe
Are you the first person in your family to go to college?
Yes
No
Who in your family has gone to college?
Did they graduate from college?
Yes
No
Contact Information
Email Address:
Cell Phone #:
(
)
-
Home Phone #:
(
)
-
Parent / Guardian Phone #:
(
)
-
Parent / Guardian Name:
Your Street Address:
Your Zip Code:
Please record your current high school GPA (or guess if you aren't totally certain).
High School & College Information
High School
Please select...
Academy of Public Service
Another Course to College
Boston Adult Technical Academy
Boston Arts Academy
Boston Collegiate Charter School
Boston Community Leadership Academy
Boston Day & Evening Academy
Boston International High School
Boston Latin Academy
Boston Latin School
Brighton High School
Brook Farm Academy
Cathedral High School
Charlestown High School
Community Academy
East Boston High School
English High School
Excel High School
Fenway High School
Greater Egleston High School
Health Careers Academy
Jeremiah Burke High School
John D. O’Bryant High School
Josiah Quincy Upper School
Madison Park High School
MATCH Charter Public High School
Media High School
Monument High School
New Mission High School
Noonan Business Academy
Odyssey High School
Parkway Academy-Technology & Health
Snowden International High School
Social Justice Academy
Tech Boston Academy
The Engineering School
Urban Science Academy
Dorchester Academy
If you know your high school GPA, please write it here (note: there are no GPA requirements to participate in Success Boston):
Please list colleges that you are considering attending next year.
What do you plan to major in (study) when you are in college? If you haven't decided, please leave the space blank.
Success Boston wants to know.....
If you have had contact with any of the following organizations, please check the box(es) next to them. If you have not had contact with any of them, please check the box which says "No Contact."
uAspire
Bottom Line
Freedom House
Hyde Square Task Force
PIC
TERI
No Contact
How did you find out about Success Boston?
Please select...
Guidance Counselor
Teacher or school staff member
Presentation by Success Boston organization
Website
Email
Friend/student involved in Success Boston
Other
Please share how you heard about Success Boston.
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