Name: 2026 HBCU Tour Registration-NOW OPEN
Start: 2026-06-21T00:00:00-05:00
End: 2026-06-26T23:59:59-05:00

Member Status (Please note that if you indicated that you are a non-member placement details will be provided after April 1, 2026.

Member
Non-Member

Name (Student)

First

Last

Date of Birth

Email (student)

Phone Number (student)

Grade entering Fall 2026

School attending Fall 2026

Current GPA

School Interest

College
Vocational
Unsure

HBCU of Interest

Have you taken the ACT?

Yes
No

If yes, please indicate the score. (If taken multiple times, list the highest score)

What area(s) of the ACT do you need more resources for or assistance with?

Do you have a current resume?

Yes
No

What is your anticipated major?

T-Shirt Size

List any allergies

List any illnesses that your child sees a licensed medical professional for on a regular basis.

Will your child need any learning or medical accommodations? If yes, please provide details.

I will consent for my child's likeness and image to be used for the advertisement and announcements of the program on all media platforms.

Yes
No

PARENTS

Name (Parent)

First

Last

Email (parent )

Phone Number (parent)

I understand that the information shared on this form is for the private use and data collection of the HBCU State of Mind College Preparatory Program and Tour and will not be distributed to other entities without prior consent.

Choice 1

I understand that the submission of the registration form does not secure a spot in the program, that a spot is only secured when the registration fee of $500 is paid.

Choice 1

2026 HBCU Tour Registration-NOW OPEN

PARENTS

Details

ADDRESS

SUNDAY WORSHIP SERVICES

WEDNESDAY WORSHIP SERVICES

2026 HBCU Tour Registration-NOW OPEN

PARENTS

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ADDRESS

SUNDAY WORSHIP SERVICES

WEDNESDAY WORSHIP SERVICES