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Personal Information

  • OK First Name is required
  • OK Last Name is required
  • OK Alive CU Member Number is required
  • OK Phone Number is required
  • OK Email is required
  • OK Address is required
  • OK Attending (Name of Accredited Institution) is required
  • OK Institution's Address is required
  • OK Major/Certification being pursued is required
  • OK Please list any academic honors received is required
  • OK Please list your community involvement is required
  • OK Write a minimum of 300-word count article/blog or produce a 1–2-minute video about the topic question: “Describe your most meaningful achievements and how they relate to your field of study and career goals.” is required
  • Please email the following items to [email protected]:

    OK Please email the following items to [email protected]: is required
    OK I certify that the information included in this application is true and correct. I understand that my submission will not be considered if I have not fully completed this application, an article/blog or video on the topic above, a current transcript and one letter of recommendation. is required
  • OK Applicant's Full Name (serves as your electronic signature) is required
  • OK Today's Date (mm/dd/yyyy) is required

Security Code

  • OK is required