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Gear Up - RSU


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GEAR UP University
2014 Application

Appreciating Real World Technology (ART)
Rogers State University, Claremore

June 22-27, 2014
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Student Information
First Name: * Middle Name: * Last Name: *
Home Address: * City: * State: * ZIP: *
County: * Cell Phone: * Email: *
Gender: * Birth Date: * Race: *
Tribe:    Tribe Name:   

Parent/Guardian Information
First Name: * Middle Name:    Last Name: *
Home Address: * City: * State: * ZIP: *
Home Phone: * Cell Phone: * Email: *

School Information
School Attended: * Phone: *
Address: * City: * State: * ZIP: *
County: *

In the space below, describe why you (the student) want to attend GEAR UP University and what you expect to gain from the experience.
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If you have questions about GEAR UP University, please email ethrower@osrhe.edu or call 800-858-1840.