College & Career Pathways Application If you are having issues submitting this application, please email eva@hydesquare.org or call 617-524-8303.What session are you hoping to start? These start dates are for the grade you will be in for the school year 2023-2024.* Fall 2023: 12th grade & recent grads. Winter 2024: 11th grade & recent grads. Summer 2024: 11th, 12th, and recent grads. How did you find out about our program?*Music Clubhouse (MCH)Social MediaSchool PresentationFlyerSchool Field Trip to HSTFTeacherFriendOpportunity FairOtherHSTF Community EventDance/Theatre at Margarita Muniz AcademyFamily MemberCurrent or Former Participant of HSTFOther: Participant InformationName:* First Last Date of Birth:* Month Day Year Age* Gender:* Female Male Non-Binary Gender Questioning Gender Transitioning Other If other, please specify:* Address:* Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Home Phone Number:*Participant Cell Phone Number (if available):*Participant Email Address:* Which of the following best describes you? Please choose one answer:* Asian or Pacific Islander Black or African American Hispanic or Latino Native American or Alaskan Native White or Caucasian Multiracial or biracial A race/ethnicity not listed here If other, please specify:* Country of Birth*BrazilCape VerdeColombiaCosta RicaCubaDominican RepublicEcuadorEl SalvadorGuatemalaHaitiHondurasJamaicaMexicoOtherPanamaPeruPuerto RicoUnited States of AmericaVenezuelaWhat school did you attend or currently attend?Academy of the Pacific RimAnother Course to CollegeBoston Adult Technical AcademyBoston Arts AcademyBoston CollegiateBoston Community Leadership AcademyBoston Day & Evening AcademyBoston Green AcademyBoston International & Newcomer's AcademyBoston Latin AcademyBoston Latin SchoolBoston PreparatoryBoston Teachers Union K-8 SchoolBoston Trinity AcademyBrighton HighBrooke 8th Grade AcademyBrook Farm Business AcademyBrooke HighBurke HighCharlestown HighCity on a HillCity on a Hill (Dudley)Codman AcademyCommunity Academy of Science & HealthConservatory LabCristo Rey BostonCurley K-8Dearborn STEM AcademyDorchester AcademyEast Boston HighEdison K-8Edward M. Kennedy Academy for Health CareersEnglish HighExcel AcademyExcel HighFenway HighGreater Egleston High SchoolHenderson K-12 InclusionHennigan K-8Hernandez K-8Irving MiddleJoseph LeeKennedy Academy for Health Careers 11-12Kennedy Academy for Health Careers 9-10Madison ParkMarbleheadMargarita Muniz AcademyMATCH HighMATCH MiddleMcCormack MiddleMcKinley South End AcademyMeridian AcademyMission Hill K-8Murphy K-8New Mission HighO'BryantParkway AcademyQuincy Upper SchoolRoxbury PreparatorySharonSnowden InternationalTecca Online SchoolTechBoston AcademyTimilty MiddleTobin K-8UP Academy DorchesterUrban Science AcademyWest Roxbury AcademyYoung Achievers Science & Math K-8Other and or MetcoIf you selected "Other and or Metco" above, please write in the name of your school below. What grade are you currently in?10th11th12thRecent High School GraduateIf you selected Recent High School Graduate above what year did you Graduate? What are your plans after high school?* Entering the Workforce Pursuing Vocation/Technical Training Earning my Associate's Degree (2 Year) Earning my Bachelor's Degree (4 year) I’m not sure/ I’m still exploring. Select all that apply to you.Are you currently enrolled/involved in any of the following:* Job Vocation/Technical Training Associate's Degree (2 Year) Bachelor's Degree (4 year) Other None of the Above Select all that apply to you.If you checked any of the above, can you share the name of the organization, program, and or job? Consent You have my consent.The information provided on this form is true and accurate to the best of my knowledge and I give permission for Hyde Square Task Force to communicate with me regarding this particular program. Participant Signature:* Parent / Guardian InformationIf you are under the age of 18 please add your parent/guardian's contact information below. Parent / Guardian Name: First and Last Relationship to Youth: AddressStreet City, State, ZIP CodeHome Phone Number:Cell Phone Number:Email Address: Parent/Guardian Country of BirthBrazilCape VerdeColombiaCosta RicaCubaDominican RepublicEcuadorEl SalvadorGuatemalaHaitiHondurasJamaicaMexicoOtherPanamaPeruPuerto RicoUnited States of AmericaVenezuelaConsent You have my consent.The information provided on this form is true and accurate to the best of my knowledge and I give permission for my child to participate in Hyde Square Task Force programs and activities.Parent / Guardian Signature: Date:* MM slash DD slash YYYY Δ
