Thomas University

Pre-College Program

1501 Millpond Road, Thomasville, GA 31792

(229) 226-1621 ext. 167 or (800) 538-9784

 Parent/Guardian and Student Application 

Purpose: The Educational Talent Search Program is designed to provide academic, cultural and social enrichment activities to promising middle and high school students and enable them to attend college or technical school after graduation from high school.

* All fields are required.

Parent/Guardian: Last First

Student: Last First

Address: Street  Georgia ZIP

Home Phone #:          Work Phone #: 

DOB:             Age:              Sex:  Male    Female

School:              Grade: 

Please give numerical Grade Point Average: 

Are you a U.S. Citizen?  Yes    No           

Race: 

Do you have any documented disabilities?   No Yes

If yes, explain:   

 

Emergency Contact:  Name     Emergency Phone #:  

Guidance Counselor/Specialist's Name: 

*Parents, please be advised that occasionally, television/newspaper crews advertise stories on after-school enrichment programs.  Also, brochures will be developed which may include photographs of children participating in the program.  If you do not want your child's photograph to be included in brochures, television or print news articles, please indicate this below. 

  Yes, you have permission to include my child's photograph in print or television media.

  No, you do not have permission to include my child's photograph in print or television media.


Dear Parent/Guardian:

The Department of Education in Washington D.C. funds the Educational Talent Search Program.  We are required to provide services to students who are potential first generation college students.  Please help us meet these criteria by completing the following questions:

Number of People living in your household:   

Your household income last year:   

Are you a single parent or guardian?   Yes No

*THESE QUESTIONS MUST BE ANSWERED*

*Does your child receive free or reduced lunch?   Yes No

*Did you or your spouse GRADUATE from a four-year college?   Yes No

If you answered No above:    Highest educational level you have completed

                                                 Highest educational level completed by your spouse 


By submitting this application, you hereby acknowledge that this information is correct to the best of your knowledge.

After you submit this application, you will be taken to the Academic Plan Form.