Ventures in Education, Inc

Ventures In Education, Inc.  15 Maiden Lane, Suite 508  New York, NY 10038 1 (800) 94-SMART  FAX (212) 566-2536  www.venturescholar.org

Ventures Scholars Program Application for High School Students The Ventures Scholars Program invites high-achieving, underrepresented students and first-generation college bound students to join the Ventures Scholars Program. Students need to meet the following academic requirements and career aspirations:

 Students must meet test score requirements on either the PSAT, PLAN, SAT or ACT PSAT: Sophomores must score at least a 47 on the math and critical reading sections. Juniors must score at least a 50 on the math and critical reading sections. PLAN: Students must score at least an 18 for the composite score with a minimum score of 16 on each section. SAT: Students must score at least a 550 on the math and critical reading sections. ACT: Students must score at least a 19 on each section.  Students need to maintain a minimum of a 3.0 grade point average, and  Students need to express an interest in a math- or science-based career.

If you qualify for the Ventures Scholars Program, you will be linked with information from the Ventures Scholars Program, member institutions, associations, and organizations.

This application will provide us with your academic, career and family information. The academic and career section requests your standardized test scores, the courses you are taking or have completed, your intended career pathway, and the colleges/universities you are interested in attending. The family information section provides us with information about your family members and your family socioeconomic status. The Ventures Scholars Program would like to link you and your family members to important programs and opportunities. Sometimes, these programs are based on your family's income and educational background.

Please note that all information provided by the student is confidential and will only be provided to member colleges, universities, and associations.

Once you are registered with the Ventures Scholars Program, you can utilize the FREE services while in high school, undergraduate school, and graduate/professional school. Please remember to regularly update your on-line registration form in January, June and September.

It is extremely important that we have your up-to-date email address because a lot of our communication is via email.

Today’s Date:

Student’s Name: First Middle Last Date of Birth: Gender: Male Female

Student’s Address:

City: State: Zip Code:

Phone Number (include area code):

Email:

Parent/Guardian Email:

of 5 Underrepresented or First Generation College Bound?: (You must check at least one.)

I am a member of an historically underrepresented group (African American or Black, Native American or Alaskan Native, Mexican or Mexican American, Hispanic, Latino, or Puerto Rican).

I am a first generation college bound student whose parents/guardians have no education beyond high school. Race and ethnicity are not factors.

Check appropriate box(es).

Ethnicity: American Indian or Alaskan Native Career Major: Asian, Asian American, or Pacific Islander Biological (Life) Sciences African American or Black Computer & Information Sciences & Mexican or Mexican American Technologies Puerto Rican Engineering & Engineering Technologies Latin American, South American, Central Health Professions & Allied Services American, or other Hispanic or Latino Mathematics White Physical Sciences Undecided

Religion (optional): No Response/Unknown Church of Brethren Judaism African Methodist Episcopal Church of Christ Evangelical Lutheran Anglican United Church of Christ Church in America Assembly of God Christian Science (Church Lutheran Church-Missouri Baha’l of Christ, Science) Synod Baptist Church of God Mennonite Southern Baptist Church of Jesus Christ of Methodist Convention Latter-Day Saints United Methodist Buddhism Church of Nazarene Eastern Orthodox Churches Christian-Disciples Episcopal Pentecostal Christian Reformed Church Hinduism Presbyterian Church (USA) of America Islam/Muslim/Moslem

Name of High School: CEEB Code:

High School Address:

City: State: Zip Code:

Phone Number (include area code):

High School Guidance Counselor: Counselor signature is required if applicant does not meet score minimum in the Standardized Test Scores section.

Signature:

High School Graduation Date: (Month/Year)

OPTIONAL

of 5 Current GPA: choose one Class Rank: I am out of a class of [minimum B (number) (number of students (83) average] in graduating class)

Standardized Test Scores Please indicate the tests you have taken, and record the test date, and scores for each exam. Seniors must meet the SAT or ACT minimum to qualify.

PSAT Date Taken Month/Year Score Math Critical Reading/Verbal Sophomores: (minimum 47) (minimum 47) Juniors: (minimum 50) (minimum 50)

SAT Date Taken Month/Year Score Math Critical Reading/Verbal (minimum 550) (minimum 550)

PLAN Date Taken Composite Score: Month/Year (min. 18) Score Math English Reading Science (min. 16) (min. 16) (min. 16) (min. 16)

ACT Date Taken Composite Score: Month/Year (min. 19) Score Math English Reading Science (min. 19) (min. 19) (min. 19) (min. 19)

Please select the regions in which you are considering attending a college/university. Middle States [DC, Delaware, Maryland, New Jersey, New York, Pennsylvania] Midwest [Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, West Virginia, Wisconsin] New England [Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont] South [Alabama, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia] Southwest [Arkansas, New Mexico, Oklahoma, Texas] West [Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, Oregon, Utah, Washington, Wyoming]

What is the number of people in your household, including yourself? Please write the number of siblings you have in each age group. 0-5 years old: 6-10 years old: 11-14 years old: 15-18 years old: Over 18 years old:

Please indicate the highest level of your parents' or legal guardian's educational background: Mother/Legal Guardian: No High School Some high school High school diploma or GED Some College Bachelor's Degree Graduate/Professional Degree

of 5 Father/Legal Guardian: High school diploma or GED No High School Some College Some high school Bachelor's Degree Graduate/Professional Degree Please indicate, for the most recent year, the range of your family's gross income as reported on the Federal and/or State Tax Return. Less than $10,000 $30,000 - $39,999 $60,000 - $69,999 $10,000 - $19,999 $40,000 - $49,999 $70,000 - $79,999 $20,000 - $29,999 $50,000 - $59,999 $80,000 or more

Please select the math and science class you are currently taking. If you are not currently taking a math or science class, please select the highest level course you have completed. Math: Science: Algebra Pre-Algebra Biology Algebra II Pre-Calculus Chemistry Calculus Statistics Earth/Space Science Geometry Trigonometry Physics

Check the AP courses you have completed or are currently taking: My high school does not offer AP courses Art History Environmental Science Latin Studio Art European History Music Theory Biology French Physics Calculus AB & BC Human Geography Psychology Chemistry German Language Spanish Computer Science Government and Politics Statistics Economics International English US History English Language World History

Are you taking IB or have you completed (International Baccalaureate) courses? Yes No

Are you taking or have you completed any college level courses? Yes No

Colleges and universities are looking for more than just academic success in their prospective students. They also consider your involvement in extracurricular activities. The Ventures Scholars Program would like to provide you with additional information about various extracurricular activities.

What extracurricular activities have you participated in? Debate/Speech Part-time Work Theatre Honor Societies Research Volunteering Music-Instruments School Clubs Other Music-Voice Sports

You must check the following in order to take advantage of the Ventures Scholars Program opportunities:

I certify that this information is complete and correct to the best of my knowledge.

I authorize the Ventures Scholars Program to provide my information to colleges, universities, and associations that will help me pursue my career goal.

Signature: Date:

of 5 Please be sure that you have completed all questions on the application and mail or fax this form to:

Ventures Scholars Program c/o Ventures In Education, Inc. 15 Maiden Lane, Suite 508 New York, NY 10038 Fax (212) 566-2536 Phone: (212) 566-2522