IIMF Virtual State College Tour - October 30, 2020 University of Northern Iowa
Student Name (First and Last Name)
Address
City
State
Please select...
IA
Zip Code
Phone Type
Please select...
Home
Cell
Phone Number (xxx-xxx-xxxx)
Email Address (
name@noname.com
).
Please double check that your email is written correctly. This is our main forms of communicating with you.
High School
Please select...
Adel High School
Ankeny High School
Ames High School
Carlisle High School
Des Moines Alternative High School
Des Moines Central Campus
Dowling High School
East High School
Home School
Hoover High School
Johnston High School
Joshua Christain Academy
Lincoln High School
North High School
Norwalk High School
Roosevelt High School
Scavo Alternative High School
Southeast Polk High School
Urbandale High School
Valley High School
Valley Southwoods High School
Waukee High School
Wyoming High School
Other
Gender
Please select...
Female
Male
Grade
Please select...
Freshman Graduating 2024
Sophomore Graduating 2023
Junior Graduating 2022
Senior Graduating 2021
Unisex Shirt Size (Adult Male Sizes)
Please select...
Small
Medium
Large
XLarge
XXLarge
XXXLarge
Ethnicity
African American/Black
American Indian/Alaska Native
Asian
Caucasian
Hispanic/Latino
Other
List 3 Colleges/Universities that you are interested in attending.
List 3 Majors/Minors that you are interested in pursuing.
Honors/Awards/Other Achievements
Clubs/Organizations
Church/Community Related Activities
Parent/Guardian Name
Parent Address (
if different from applicant
)
City
State
Zip Code
Phone Type
Please select...
Cell
Home
Work
Phone Number (xxx-xxx-xxxx)
Email Address (
name@noname.com
)
Parent/Guardian Name
Address (if different from applicant)
City
State
Zip Code
Phone Type
Please select...
Cell
Home
Work
Phone Number (xxx-xxx-xxxx)
Email Address (
name@noname.com
)
I certify that information provided in this application is true, complete, and accurate. Participation in Investing In My Future State College Tour 2020 may be denied or revoked if any information contained herein is found to be inaccurate. Should I receive an opportunity to participate in the Program, I hereby give Investing In My Future State College Tour 2020, its donor, sponsors, and members permission to utilize my name and award amount in publicity and/or marketing materials.
Yes
No
To participate in all activities organized by or through Investing In My Future State College Tour, I grant permission to make photographic records (website, newletter, fliers) for promotional purposes without recourse or compensation.
Yes
No
Contact Information