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First Name:  Please enter your name 
Last Name:  Please enter your name 
Email Address:  Please enter your email   Please enter a valid email 
Phone Number:  Please enter your phone 
Do you have a US social security number?: Yes
No  You must select Yes or No  
Citizenship: US Citizen
US Permanent Resident
Non-US citizen  Please select your citizenship 
Eligible US co-signer? Yes
No  Please choose one option 
Grade Level:  Please select your grade level 
Permanent Residence:  Please select your home state 
School Location:  Please select your college state