College Assistance Migrant Program (CAMP) Interest Form

Name Name * First Last
Email *
Phone Phone * - ### - ### ####
Mailing Address Mailing Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Current UNG Student?

Current UNG Student? Yes No
Number of Credit Hours
High School *
Grade *
Current Cumulative GPA
SAT Combined Score (if any)
ACT Combined Score (if any)
Date of Birth Date of Birth / MM / DD YYYY
Mother's Name Mother's Name First Last
Father's Name Father's Name First Last
Please check one (if unknown, leave blank):

Please check one (if unknown, leave blank): Migrant: You are in the Migrant Education Program in your school, OR you have been in the Migrant Education Program at some point during your k-12 education. Seasonal/Temporary: You OR your parent’s employment is in agriculture and is not considered year-round.
Comments/Questions/Notes: