Personal Information × Birth Date × First Name × Last Name × Street Address × City × State - None -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming × Zip Code × Home Phone Number × Cell Phone Number × Email Address × Ethnicity × First Term at North Central × Race × Anticipated Major × Career Aspiration × Name of High School Are you a First Generation Student? × Yes × No × Not Sure First-generation students come from families where their parents did not complete a four-year degree. Will you be an on campus resident or commuter? × Resident × Commuter Are you participating in the College Scholars Honors Program? × yes × No × Not Sure Are you participating in the Cardinal Athletic Band, Color Guard, Dance Team or Cheer Team? × Yes × No × Not Sure × Are you planning on participating in any extra-curricular activities at North Central? If so, which ones? × Are you competing in any NCAA recognized intercollegiate athletic teams for North Central College? (i.e. football, soccer, track). If so, which one(s)? × Please list any food allergies or dietary needs during the program × Please list any medical concerns we should be aware of during the program × Please list any accommodations needed during the program (i.e. physical or language restrictions) × Please indicate your t-shirt size - None -Men's SmallMen's MediumMen's LargeMen's XLargeMen's XXLargeWomen's SmallWomen's MediumWomen's LargeWomen's XLargeWomen's XXLarge Please answer the following questions × How do you think you would benefit from participating in the Premier Scholars Program? × What type of challenges have you had to overcome in your life thus far? × What do you hope to accomplish (career/life goals) after you complete college? × Please explain any possible schedule conflicts between Thursday, August 1, 2019 and Monday, August 12, 2019 × Is there anything else you would like the Premier Scholars Program staff to know about you? × Math question * 8 + 3 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.