For more information about CAMP and the application procedures, print this form and mail it to:

Texas A&M University-Kingsville
Special Programs-CAMP
MSC 181
Kingsville, TX 78363

Name: ________________________________________

Social Security Number : __________________________

Date of Birth : __/__/__ (MM/DD/YR)

Tel no : (    )-_____________

Mailing Address : ________________________________
                          
                            ________________________________

High School : __________________________

City : _________________

Graduation Date : ________________

School Phone : (  )- ______________

Classification:
___HS Senior                            ___HS Graduate
___GED Graduate                     ___College Freshman
___Other

When do you plan to attend TAMUK?
_________________________________________________

Registered as  Migrant is school (COE)?
__Yes        __No

Are you a Seasonal Farmworker?
__Yes        __No

Can you provide verifiable information?
__Yes        __No

Are you a US Citizen or Registered Alien?
__Yes        __No

Are you a Texas resident? __Yes     __No

Comments: _________________________________________
                   
                  _________________________________________

                  _________________________________________

                 __________________________________________