High School Workshop RegistrationEssay Writing Part 1Monday, October 19, 2026DMACC Urban Campus Building 71144 7th Street, Room #231, 2nd Floor, Des Moines, IA 5:00 pm

Student Information

First Name

MI

Last Name

Address Line 1

Address Line 2

City

ZIP Code

Student Email Address (personal email)

Student Phone Number (xxx-xxx-xxxx)

Student School Information

High School

If you picked "other" for High school, please enter the name below.

Graduation Year & Grade

Age

Demographics

Ethnicity

Hispanic/LatinoNon-Hispanic/Non-LatinoEthnicity Unknown

Gender

FemaleMaleNon-BinaryOther

Receive Free/Reduced Lunch

YesNo

Refugee Status

RefugeeNot a RefugeeRefugee Status Unknown

First Name

Last Name