Student Name
CIF Number
Parent/Guardian name
Address
City
State
ZIP
Phone
Email Address
Enrolled at Harding for 2006-07
Yes
No
Current School
Current Grade
Are you currently in AVID?
Yes
No
Current G.P.A
Do you dream of going to college? Why or why not?
Why do you want to be in AVID How do you think AVID will help you?
Date
January
February
March
April
May
June
July
August
September
October
November
December
/
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
2006
2007
2008
2009
2010
2011
2012
(now)
[
Finish
]
