First Name *

Last Name

Phone

Email *

School Name *

Grade Level *

SHS Strand *

Preferred Course or Program in College: *

I certify that all information provided in this form are true and correct. I give my permission to the University of the East to process my information in line with the chosen program/course I intend to take in college. I agree to be contacted by representatives of UE through various means with regard to present and future program offering and admission information. I understand that my personal information will be kept in secure location and will be part of UE’s database of students who participated in its School-to-School Program.