Microsoft-EBF 2020 Virtual Summer STEAM Mentorship Program Registration Form STUDENT FULL LEGAL NAME (exactly as printed on your passport or other government-issued ID) Last/Family/Sur name(s) * First/Given name(s) * Middle name(s) Preferred Name * PRESENT MAILING ADDRESS Street and Number * City * State/Province * Zip/Postal Code * CONTACT INFORMATION Student Home Phone Student Cell Phone Student E-Mail Address * Parent Last Name * Parent First Name * Parent Cell Phone * Parent E-Mail Address * SCHOOL ADDRESS School Name * CEEB Code Street and Number City State/Province Zip/Postal Code Education Some High School High School Diploma Date of Graduation Date of Birth Gender Male Female Citizenship US Citizen US Permanent Resident International student [ You must include Form HS-F with this application. Please fax to (404) 943-0015 ] ETHNICITY (voluntary; US citizens and permanent residents only) Do you consider yourself to be Hispanic/Latino? Yes No In addition, please select one or more of the following racial categories to describe yourself: Black or African American American Indian or Alaskan native Asian Native Hawaiian or other Pacific Islander White Δ