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Bustin’ Out Blue Registration

Name*
First Last
Address*
Street Address City State ZIP Code
Home Phone
Cell Phone
Email*
Enter Email Confirm Email
Date of birth*

Month

Day

Year
Program of Study*
High School*
Graduation Year*
How many guests will be accompanying you?*
Hidden
Would you like to make a FAFSA Completion appointment that day between 1pm-3pm?*
- Yes
- No
If so, you will need to bring your 2021 tax return with you (student and parent will need to be present for the appointment)

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