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Kids 2 College Campus Application

Campus Details

• Prospective Host Campus: *

  ==Please select==Anchorage APUAnchorage UAABarrow Llisagvik CollegeBethel Kuskokwim CampusDillingham Bristol Bay CampusFairbanks UAFFairbanks UAF-CTCGlennallen PWSCC Copper Basin CampusHomer Kenai Peninsula College Kachemak Bay CampusJuneau UAS JuneauKetchikan UAS KetchikanKodiak Kodiak CollegeKotzebue Chukchi CampusNome Northwest CampusPalmer Mat-Su CollegeSitka UAS SitkaValdez Prince William Sound Community College
• Campus Coordinator: *
• Coordinator’s Email: *
• Direct Phone: *
• Cell Number:
• Shipping Address: *
• City: *
• Zip Code: *
• Immediate Supervisor: *
• Supervisor Email: *
• Supervisor Direct Phone: *

School Information

• Please check with your schools and select your top 3 visit dates.

• Campus Visit Date: *
• Campus Visit Date: *
• Campus Visit Date: *
• Student Arrival Time: *

  ==Please select==8 am830 am9 am930 am10 am1030 am11 am1130 amNoon1230 pm
• Student Departure Time: *

  ==Please select==Noon1230 pm1 pm130 pm2 pm230 pm3 pm
• Max # Students per Event: *
• # of Events: *
• List your Preferred School(s):

Curricular Support

• Please explain the support you plan to give the school.

• Required Support

• Lesson 5 College & Career Panel:

• Optional Engagement

• Pre-Surveys:
• Post-Surveys:
• Lesson 1:
• Lesson 2:
• Lesson 3:
• Lesson 4:

Campus Event & Materials

• Campus Event: *
• Campus Visit: *
• Opening Ceremony: *
• Backpack Distribution: *
• Media Outreach: *
• Closing Ceremony: *
• # K2C Instructors/Classes: *
• # Volunteers: *

• Our Campus Would Like Templates for

• Certificate: *

  Yes
  No
  
• Name Tags: *

  Yes
  No
  

Program Costs

• Local Sponsors & Associated Organizations:
• Lunch Cost: *
• Max Amount Campus: *
• Estimated Total Cost :
• Estimated Total Cost :

Supplies Remaining (prior year)

• Student Workbooks: *
• Teacher Guides: *
• Backpacks: *

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