Student & family interest form

Let’s start with your family’s goals.

This five-minute form helps the Rising Scholars team understand who is interested, what support families need, and how to follow up. It is not a formal application.

About 5 minutesParent-guidedNo documents required

1 Family2 Student3 Goals4 Consent

1 Parent or guardian

Please have a parent or legal guardian complete or supervise this form.

First nameLast nameEmail addressPhone numberPreferred contact method

2 Student information

Student first nameStudent last nameStudent age rangeCurrent gradeSchool nameHome ZIP codeExpected graduation yearApproximate unweighted GPA

3 College goals and support

How interested is the student in attending college?What support would be most helpful?How did you hear about Rising Scholars?Anything else you would like us to know? Optional

4 Consent and privacy

How we use this information

RDCF will use these details to assess program interest, conduct eligibility follow-up, communicate with your family, and plan services. Access is limited to approved program staff. Do not submit sensitive documents or identification numbers here.

Your information is submitted securely. We will never ask for payment through this form.