Student Registration

Student First name

Student Last name

Student Birthday

Student Address

Studenty identify's as

Female

Male

Student identify's their ethnicity as (select all that apply)

Black/African American

Caucasian/American

Latin/Hispanic

Other

Student Grade Level

Student School

Student Phone

Student Email

Parent/Guardian Full First & Last Name (if student under 18)

Parent/Guardian Email (if student under 18)

Parent/Guardian Phone (if student under 18)

Emergency Contact Full name

Emergency Contact Phone

Emergency Contact Email

Emergency Contact Address

What industry of business is the student intrested in?

Choose a Workshop Date

Scholarship Application : Why should your student/self receive a scholarship? (Please allow the student ONLY to fill this out)

Signature

Consent for Participation: I, the undersigned, give permission for my child/self to participate in the BSOY (TYE) program. I understand that this involves attending workshops, completing assignments, and engaging in related activities designed for educational purposes.

Permission to Use Photos or Videos: I authorize the TYE program to take photographs and videos of my child/self during program activities. I understand these images may be used for promotional, educational, or marketing purposes.

Confirmation of Terms Please confirm your agreement to the following by checking each box:

I have read and agree to the terms and conditions of participation in the TYE program.

I understand and consent to the use of photos or videos of my child for promotional purposes as outlined above.

I acknowledge that I am responsible for ensuring my child’s/Self attendance and participation in all program activities.

Student Scholarship Application