Manchester College Achievement Program (C.A.P.)


College Achievement Program Participant Online Application

Note: To download a print version of this form, click here.

Academic Counseling
ADAPT
Employment at Academic Support
Meet the Staff
Peer Tutoring
Study Tables
Services for Students with Disabilities
Section A - Student Information
Last name First name Middle initial
Address City State
Zip Birthdate
mm/dd/yyyy

Home phone Cell
phone		 E-mail
Best form of contact School
name		 Grade
Expected graduation year Did you join the 21st Century Scholars program in the 8th grade?
Primary language spoken in your home
OPTIONAL: While the following is not a requirement for admission to the program, it would help us in learning more about you.
Ethnicity Are you a U.S. citizen? If no, country of citizenship
Section B - Miscellaneous Information
Do you have a computer available at home?


Do you have internet access at home?


If yes, indicate type:
Do you have any siblings currently attending college?


Do you have any siblings who have completed college?


Do you plan to go to college?


 
Section C - Parent/Family Information
Family size (including applicant) Single parent household?


       
Parent/legal guardian 1  
Name Work/day phone Cell phone
E-mail Highest level of formal education
 
Parent/legal guardian 2  
Name Work/day phone Cell phone
E-mail Highest level of formal education
 
Section D - Personal Statement

Please enter (or copy and paste) a 300-word personal statement that addresses all of the following:

  1. Why would you like to participate in this program?
  2. What do you hope to achieve as a result of completing the program?
  3. Why is becoming better prepared for college important to you?
  4. How will you maintain your commitment to participate in the program through graduation?

(Maximum characters: 2000 for approximately 300 words)
You have characters left.
If you have questions or concerns about the application or Manchester C.A.P., please e-mail Kim Myers or call 260-982-5591.