High School Scholar Program Application * required fields Student Information First Name: * Last Name: * Address: * City: * State: * Zipcode: * Country: * Phone: * Email Address: * Birthday: * Social Security Number: * Guardian Information First Name: * Last Name: * Phone: * Email Address: * High School Information High School: * Address: * City: * State: * Zipcode: * Country: * Graduation Date: * Course Information Course Selection: * Ex: Fall 2012, Spring 2012 First Choice Department: * Number: * Title: * Second Choice Second Choice or Second Course Department: Number: Title: Yes No Have you participated in this program before? * If yes, please indicate term/year: Ex: Fall 2012 Country of Citizenship: * Country of Birth: * If not a U.S. citizen, are you a permanent resident of the U.S. (i.e. "green card" holder?) Do you currently have a U.S. visa? How long have you resided in the U.S.? Primary language spoken at home? TOEFL/IELRS/STEP Score: Please select one or more of the ethnicities that best describe you : Hispanic/Latino (including Spain) American Indian or Alaska Native(including all Original Peoples of the Americas) Asian (including Indian subcontinent and Philippines) Black or African American(including Africa and Caribbean) White(including Middle Eastern) Native Hawaiian or Other Pacific Islander(Original Peoples) I have read and understood the parameters of this program, and I agree to abide by the stipulations. Chatham University Honor Code Honor is that principle by which we at Chatham form our code of living, working and studying together. The standards of honor at Chatham require that all students act with intellectual independence, personal integrity, honesty in all relationships, and considerations for the rights and well-being of others... And this is where honor applies â€” in all aspects of Chatham life.