Your form has been saved as a draft. If you need to stop working on this form and continue it later, you may find the form in the pending / drafts section under "My Forms"
Close Window
For security reasons, your session will end in two minutes. Please save your work to avoid timeout.

Gear Up - RSU


* = required field
RSU Logo

Gear Up University

Appreciating Real World Technology (ART)
Rogers State University, Claremore
June 12-17, 2016

Student Information

*
First Name: * Middle Name: * Last Name: *
Home Address: * City: * State: * ZIP: *
County: * Cell Phone: * Email: *
Gender: * Birth Date: * T-shirt Size: *
Race: * Tribe:    Tribe Name:   
*
*
*

Parent 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.
*

If you have questions about GEAR UP University, please email ethrower@osrhe.edu or call 800-858-1840.