Homeschool Day

* First Name:	*Required
* Last Name:	*Required
* Gender:	- Select - Male Female *Required
* Birthdate:	*Required
* Address:	*Required
* City:	*Required
* State:	- state - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware D.C. Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ____________________ AA AE AP AFO APO FPO AS-American Samoa FM-Micronesia GU-Guam MH-Marshall Islands MP-N.Mariana Islands PW-Palau PR-Puerto Rico VI-Virgin Islands Other, not listed *Required
Zip:
* Phone Number:	*Required
* Email Address:	*Required
High School Name:
* Year of High School Graduation:	*Required
College major most interested in pursuing:	- Select - Business Education Exercise and Sports Science Fine Arts Language & Literature Math & Science Religion & Philosophy Social Sciences
If interested in college-level athletics, which sport?
Number of people who will come with you:

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