Student Scholars Reception for Charlotte CIAA
Claflin University, Orangeburg, South Carolina


Number of people attending event (including student)
 
Student's Name
Last Name
First Name
Middle Name
 
Address
Street
City
State
Zip
 
Phone
Home  
Cell  
Email  
 
Name of High School Student is Currently Attending
High School Graduation Date
Intended Academic Major
I plan to begin college in
Are you transferring from another college/university?
 
SSR