Future Teacher Program

Date: August 25-29, 2013

Name:
High School:
Home Address :
City, State, ZIP:
Cumulative GPA:
ACT score:
Gender: Male Female
Home Phone :
Cell Phone :
E-mail Address :
 
Have you been admitted/accepted to UW-Whitewater?
Yes, I have been admitted No, I have not been admitted
 
What Major & Minor do you intend to enroll into at UW-Whitewater?
 
Ethnicity (Check all that apply):
African-American
Asian
Hispanic/Latino
American Indian
Caucasian/White
Southeast Asian (Vietnamese, Hmong, Cambodian, Laotian)
Other  
T-Shirt Size
Small Medium Large X-Large 2X-Large
In 250 words or less, please explain why you should be accepted into the Future Teachers Summer Institute.
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