Response

Primary Contact

Prefix

First Name

Last Name

Address Line 1

Address Line 2

City

State

Zip

Phone

Are you the: Parent
Student
Other

Have you graduated from college? Yes
No
Prefer not to stay

Are you first generation college student? Yes
No
Prefer not to stay

Do you want a College Savings Team Member to contact you? Yes
No

Preferred Method of Contact Email
Phone
U.S. Mail

Do you want to receive information on the following: Student Loan Ombudsman
Governor Guinn Millennium Scholarship
Nevada College Kick Start
Pre-Paid Tuition
529 Plans
Scholarship Opportunities
Post Secondary Education Planning or Prep

Where did you hear about the program? TV/Radio/Website
Social Media
Event

Social Media Facebook
Instagram
Twitter
Linkedin

Event School Event
Community Event
Webinar
Virtual Event

Grade Level

How do you identify? Male
Female
Prefer not to stay

What are your preferred pronouns? She, Her, Hers
He, Him, His
Other

Pronouns - Other

Primary Language - Other

Are you Hispanic, LatinX, or of Spanish origin? Yes
No
Prefer not to say

High School Name (If applicable)

High School Graduation Year (If appliable)

What is your household size?