ELI Application – Contact Information Form 2023 ELI - Contact Information Form Basic Information First Name * First Last Name * Last Preferred Name * If you have a name other than your legal name that you would like to go by, please list it here. Parent or Guardian Names * Date of Birth * Gender * T Shirt Size * Small Medium Large X Large XX Large XXX Large Contact Information Non-School Related Email (School emails will not work on our system.) * County of Residence * Mailing Address * City * State * Zipcode * Student Phone Number * Parent Phone Number * School Information County of School * Name of School * Counselor Name * Current Unweighted GPA (This needs to match the transcript you provide) * List up to two honors classes, advanced level courses, or AP classes you have taken. They need to be listed on the transcript you provide. * Have you participated in any of our other youth programs? * Select which programs you've attended Rogers Scholars Rogers Explorers Both None captcha If you are human, leave this field blank. Δ Are you struggling with the application? Click Here to Ask for Help