College Reach-Out Program (CROP) Application
Student Information:
First Name *
Last Name *
Middle Name Initial
Permanent Address *
Permanent City *
State *
Zip Code *
Cell Phone Number *
Email Address *
Date of Birth *
Gender *
Race/Ethnicity *
School Information:
School Name *
Current Grade *
Current GPA *
School ID *
FLEID Number (can be found in portal under student ID number)
Are you enrolled in the free or reduced lunch program at your school? *
As of today do you plan to attend college? *
If you answered yes above, what major?
Current Math Class *
Have you passed the Algebra 1 EOC? *
Have you passed the FSA or FAST? *
How can the CROP Program assist you as a participant? Feel free to elaborate more in the next question. *
What would you like the CROP Program to help you with? *
Have you taken the SAT, ACT, or CLT? *
Parent/Guardian 1 Information:
First and Last Name *
Address *
City *
State *
Zip *
Home/Cell # *
Email Address *
Level of Education *
Relationship *
Preferred Contact Method *
Marital Status *
Parent/Guardian 2 Information:
First and Last Name
Address
City
State
Zip
Home/Cell #
E-mail Address
Level of Education
Relationship
Preferred Contact Method
Marital Status
Family Income:
Check appropriate family income *
Total Number of Household *
Does the family receive Public Assistance? (Yes or No) *
I hereby give permission for the child listed on this application to participate in the College Reach-Out Program (CROP) and its activities. I also give permission for copies of my child's school records, including transcripts and test scores, to be released to CROP. 
Signature of the Parent/Guardian *
Signature Type: Simple    Start Over
Signature: (Type in your full name)
I agree to the terms included.
Today's Date *
Attach Student's GradeTrack Report or Screenshot of Report Card *