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Oregon Academy - Outstanding Student Application Form

1.

Please complete the application completely.

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* 1. Please enter your permanent address information.

Name:

Address:

City/Town:

State:

ZIP/Postal Code:

Country:

Email Address:

Phone Number:

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* 2. Are you a current Academy and Oregon Academy member?

Yes

No

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* 3. Your Academy membership number:

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* 4. Please enter your school/current information.

School:

Address:

City/Town:

State:

ZIP/Postal Code:

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* 5. I am currently enrolled in:

Undergraduate - Coordinated Program

Dietetic Internship

Undergraduate - Didactic Program

Graduate Program

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* 6. Please enter your information:

Major field of study:

Cumulative GPA:

Last semester GPA:

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* 7. Please upload your resume/CV here.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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* 8. Please upload your unofficial transcript here.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.