School Year: 2017    Survey: 2017-18 Arizona GU 1st Yr student info

Please complete this to allow GEAR UP to contact you via text, phone, or email next year (2018-2019) with information and support to help you after high school.
1. Your first name:

2. Your last name:

3. Your student ID number:

4. Your Cellphone Number:
Please provide your personal cell phone number (that you will use next year). If your cellphone number is from outside the U.S., skip to the next question.
Cellphone Number
5. Email Address:
Please provide the email address that you will use next year, e.g., a yahoo or gmail email address.
6. Alternate email address:
Please provide a second email address that you will use next year, if applicable, e.g., your college email address.
Alternate Email
7. Parents' primary phone number: 
Please provide your parents' primary phone number. This can be a U.S. number or an international number: 
Parents' Number
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