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RBC RBCP Info System

 

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Prospect Information Form

  

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Information Please enter the requested information. Please note that an asterisk denotes required information.

Required - indicates a required field.
Prospect Name
Prefix:
First Name: Required
Middle Name:
Last Name: Required
Suffix:
Nickname:

Primary Address
Valid From: Month Day Year (YYYY)
Until: Month Day Year (YYYY)
Address Line 1:Required
Address Line 2:
Address Line 3:
City:Required
State or Province:
ZIP or Postal Code:
County:
Nation:
Phone Number: - (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:

Prospect Birthdate
Date of Birth:Required Month Day Year (YYYY)

E-Mail Address
E-mail Address:
Verify E-mail Address:

Prospect Citizenship
Citizenship:

Prospect Ethnicity/Race
Ethnicity:

Note What is your ethnicity?

Hispanic or Latino
Not Hispanic or Latino

Note Select one or more races to indicate what you consider yourself to be.

American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Race Unknown Hispanic/Latino of any race Non-Hispanic of Two or More Races
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Unknown
Hispanic/Latino of any race
Non-Hispanic of Two or More Races

Prospect Gender
Gender: Male Female Not Specified

Prospect High School
Home Schooled (check for yes):
OR
High School Code:
High School Name:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
ZIP or Postal Code:
Nation:
Graduation Date: Month Day Year (YYYY)
Class Rank and Size: / (must be numeric)
GPA: (example: 9.99, or A+)

Prospect Prior College
College Code:
Prior College Name:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
ZIP or Postal Code:
Nation:
Attended From:
Attended To:
Graduation Date: Month Day Year (YYYY)
GPA: (example: 9.99)
Degree:

Prospect Entry Term
Term of Entry:Required

Prospect Student Type
Student Type:Required

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