Summer Bridge First-Year Experience Application *All Fields Required First Name Last Name Birth Date Personal e-mail address (we recommend not using your high school e-mail account because that might inactivate after you graduate) Telephone Mailing Address City State —Please choose an option—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaVirgin IslandsWashingtonWest VirginiaWisconsinWyoming Zip Code High School —Please choose an option—Thornton TownshipThornwoodThornridgeTF NorthTF SouthHillcrestOak ForestBremenTinley ParkOther Are you a graduating Senior —Please choose an option—YesNo Do you plan to attend SSC in the Fall? —Please choose an option—YesNo What do you want to study? (If unsure please type undecided) How did you hear about the SSC Summer Bridge First-Year Experience Program? —Please choose an option—PresentationFlyerCounselorTeacherFriendOther Why are you interested in participating in the SSC Summer Bridge First-Year Experience Program? What are your Math SAT/ACT Scores What are your English SAT/ACT Scores What is your GPA? (on a 4.0 scale) Do you have available transportation to attend the program each day? —Please choose an option—YesNo Please leave this field empty. Do you expect any of the following obstacles to prevent you from taking part in the Summer Bridge Program? (Hold down SHIFT key and click the items that apply.) —Please choose an option—NoneWork ConflictInternet AccessDigital DevicesOther If you chose OTHER above, please explain. Do you have an IEP or an 504? —Please choose an option—YesNo Do you agree to attend program/class sessions on all scheduled days? —Please choose an option—YesNo
