Pathways to Success REGISTRATION

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Pathways To Success Registration


    Application Deadline – July 15

    Program Requirements:

    • Be tobacco, alcohol, and drug-free

    • Maintain a minimum B grade point average

    • Attend a minimum of 80% of the leadership training sessions

    • Complete forty-six volunteer hours

    • Complete CAP (College Achievement Program)

    Participant Name *

    Date Of Birth *

    Grade Completed *

    Gender MaleFemale

    School *

    Participant Email *

    Participant Phone *

    Address *

    City *

    State *

    Zip *

    Parent/Guardian Name *

    Parent/Guardian Email *

    Parent/Guardian Cell Phone *

    I have special medical needs or food allergies. *
    YesNo

    If yes, please explain:

    VOICE has permission to seek emergency medical care for the participant. *
    YesNo

    VOICE has permission to take and use photos/videos of the participant. *
    YesNo

    I understand that all requirements must be completed to receive a $500 college scholarship. The scholarship must be used at a Texas college within one year of high school graduation.*
    YesNo

    Attached

    One-page essay stating why you want to participate

    Transcript or report card with a minimum B grade point average

    Two personal references from nonrelatives

    1. Personal Reference Name

    1. Personal Reference Email

    1. Personal Reference Phone

    2. Personal Reference Name

    2. Personal Reference Email

    2. Personal Reference Phone