Summer College for High School Students at The University of Mississippi

Instructions

First Name:		*
Middle Name:
Last Name:		*
Preferred Name:
Student Phone Number:		*
Student Email Address:	You must have an '@' symbol in a valid email address. You may only add 1 email address. There must be at least one period following the @ sign in this e-mail address.	*
Date of Birth:		*
T-Shirt Size:	Small Medium Large X-Large XX-Large	*
What is the name of your High School?		*
What grade will you enter this upcoming fall?	10th 11th 12th	*

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Parent's First Name:		*
Parent's Last Name:		*
Parent's Phone Number:		*
Parent's Email Address:	You must have an '@' symbol in a valid email address. You may only add 1 email address. There must be at least one period following the @ sign in this e-mail address.	*

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Describe an example of when going "above and beyond". What was expected of you, benefited you, your family, or your community?

What do you want to major in in college, and how do you intend to apply it after graduating?

How do you envision the future of STEM and athletics?

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Type the result of the following: 3 + 7 =
(used to deter automated spam submissions)

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