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LevelUp Texas Student Information Request

By completing this form, you are consenting to receive communication from LevelUp Texas, powered by Texas A&M University.

* Indicates a required field or an issue in the form.

Parent/Guardian Information

Relationship Type*

First Name*

Last Name*

Country

Street

City

Region

Postal Code

E-mail Address*

Student Information

Student First Name/Given Name*

Student Middle Name

Student Last Name/Family Name*

Student Birthdate*

Current Grade Level*

HIDDEN Prospect Type

Student School District*

Student School District Location (Type the name of the city the school is located in the box)*

Student ISD (do not use)

What post-secondary opportunities is your student considering? (Check all that apply)

Trade School

2-year School

4-year School

Military

Work

Which of the following interests most appeal to your child? (Check all that apply)

Playing Sports

Exploring the World

Creating Something

Serving Others

Leading Projects

Being Outdoors

What is your child's favorite subject in school?

Science

Math

Social Studies

English/Reading

Fine Arts

Athletics

Foreign Languages