Proctor Academy

Student Information

First Name

Preferred First Name

Family/Last Name

Birthdate

Sex

Female

Male

Non-binary

I would like to provide information about my gender identity.

Gender Identity:

Phone Number

I would like to opt in to receive SMS and telephone calls that deliver AI messages that provide details about Eckerd College*

Yes

No

Email Address

Mailing Address

Country

Street

City

Region

Postal Code

Parent Email Address

Academic Information

* Transfer Domestic/International - only for students who have graduated from high school and attending college/university.

Entry Term

Current School

GPA (Self-reported)

Intended Major/Academic Interest(s):

Extracurricular Interests (non-sports):

Sports