Civic Education Project: service learning field studies for oustanding middle and high school students
CTD's Civic Education Project
Application Form



Application Progress
Section A: Applicant Information

Please have complete application information, including student essay and credit card payment, on hand before beginning this application. It is not an option to save and return to this application to complete at a later time.
*First Name
Middle Name
*Last Name
*Gender  
*Date Of Birth (mm/dd/yyyy)
*Street Address
*City
*State
*ZIP
*Home Phone (xxx-xxx-xxxx)
Student Cell Phone (xxx-xxx-xxxx)
*Student E-mail Address
Admissions materials are sent electronically to the student and parent/guardian e-mail addresses provided.
Race/Ethnicity
Optional — No information you provide will be used in a discriminatory manner.
*T-shirt Size      
* denotes required field