Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.XiXi Registration Form Student Name *FirstMiddleLastEmail *EmailConfirm EmailBirth Date *GenderMaleFemaleAddress *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *WorkCompanyWho Referred You *XiXi Membership Plans *XiXi Ambassador Program $22.22/monthHumanitarian Scholarship $99/monthDouble Blessing Scholarship $149/monthTrinity Scholarship $199/monthNOTE: Subscriptions automatically renew each month >>>XiXi Student Ambassador Program (earn by referring others) – $22.22/mo >>>XiXi Humanitarian Scholarship (includes $22.22 membership plus sponsors 11 students) – $99.00/mo >>>XiXi Double Blessing Humanitarian Scholarship (includes $22.22 membership plus sponsors 22 students) – $149.00/mo >>>XiXi Trinity Humanitarian Scholarship (includes $22.22 membership plus sponsors 33 students) – $199.00/mo Stripe Credit Card * Referred You Card Social Security Number *Used only for scholarship tax reporting or identity verification. Securely stored and never sharedCustom Captcha * = Submit
