College Bound Academy Programs

Staff Request Meeting Form

Please fill out this form completely.

Date MM/DD/YYYY

Name of College Bound Program:

Parent/Guardian Name:

Parent/Guardian Email Address:

Parent/Guardian Cell Phone: - (###) - #######

Name of CB Scholar:FirstLast

Grade of CB Scholar:

Name of School:

Date Proposed Meeting Date: MM/DD/YYYY

Purpose of the Proposed Meeting:

Anything else CB staff should know before attending the meeting?

Leaf Blanc