Poland Regional High School

*First Name

Middle Name

*Last Name

Suffix

Preferred First Name (if different)

*Birthdate

Contact Information

*Email Address

*Mailing Address

Country

Street

City

Region

Postal Code

Preferred Phone Number

*Would you like to opt-in to receiving texts from the Bates College Office of Admission?

Yes

No

Mobile Phone Number

Academic Information

*Type of Applicant

First Year

Transfer

*In which term do you plan to enter?

*High School Name

School CEEB Code

*High School Graduation Date

Academic Interests

Co-Curricular Interests

Background Information

Sex as listed on your birth certificate

If you wish to provide more details regarding your sex or gender identity, you are welcome to do so.

Hispanic

Yes

No

Race (optional - check as many boxes as applicable)

Will you be a first-generation college student?

Bates College defines a first-generation college student as an individual whose parents/guardians did not complete a Bachelor's degree; or if the individual resides with and receives support from only one parent/guardian, that parent/guardian did not complete a Bachelor's degree.

Will you be a first-generation college student?

Bates College defines a first-generation college student as an individual whose parents/guardians did not complete a Bachelor's degree; or if the individual resides with and receives support from only one parent/guardian, that parent/guardian did not complete a Bachelor's degree.

Yes

No

Primary Citizenship

Dual Citizenship

Connect

Connect

Poland Regional High School