Civic Scholars Application 2016 Question Title * 1. First Name Question Title * 2. Preferred Name (nickname) Question Title * 3. Last Name Contact Information Question Title * 4. Email Address Question Title * 5. What is the best way to contact you? Email Phone Through a teacher or student advocate (please provide their name and email address) Question Title * 6. Phone number (if this is how you would like us to contact you) Question Title * 7. Teacher or student advocate name and email address (if this is how you would like us to contact you) Next