Your Information

Your Name (required)

Your Age (required)

Gender (required)
---MaleFemale

What is your Ethnicity? (required)

What is Your Email? (required)

Phone Number? (required)

Create 8 Digit BIP Token Password [Copy and Save] Use Numbers,Symbols,Letters

What are your CTAE Pathways interest?
TechnologySportsMusicFashionFilm

Instagram User Name

City

State

Zip (required)

General Information

What Is Your Favorite Restaurant?

What Toothpaste Do You Use?

What is Your Favorite Hair Care Product?

Do you eat BREAKFAST before school day begins?

What Music Genre Do You Like? POP, Rock, Hip Hop, RandB, Gospel, Afro Beats?

Do You Have an Iphone or Android?
---AndroidIphone

What Is Your Favorite App?

AUTO (Optional -16 Years Or Older)

Would You Like Support With Your 1st Vehicle?
---YesNo

Do you use At&T,Metro,Boost,Verizon,Tmobile, GenMobile?
Would You Like To Learn About Financial Technology

Do you prefer Debit Card or Digital Wallet?

Would You Like A Free Savings Account For College?
---YesNo

Are You Ready To "Win" 2025 4th District CONGRESS APP CHALLENGE?
---YesNo