College and Career Prep Program ApplicationFinal Application Due Date: January 10, 2023 Name * First Name Last Name Grade * 11th 12th Email (preferably not a school email) * Parent/Guardian Contact * Phone Number Are you employed? Yes No Do you plan to complete college? Yes No Not sure yet Please list all extracurricular activities and times (tutoring, jobs, sports practices, etc.) Would you feel comfortable receiving tutoring? Yes No What school subject is the most difficult for you right now? What do you hope to get out of the program? Thank you! Your application has been received. Follow us on Instagram for updates about the program!@GirlsThatRock_