Social Security #   
Date of Birth   
Current High School   
Name   
               First   MI   Last  
Preferred First Name   
Phone   
Email   
Address  

Grad. Year   
Est. GPA   
ACT/SAT   

Other Interests  

Student Government   Newspaper   Cheerleading   Music   Drama   Other:

Sports:    Basketball    Baseball    Soccer    Softball    Tennis

Optional Information  

Race:   White   Black   Hispanic   Asian/Pacific Islander

American Indian or   Alaskan Native Tribe     Sex:   Male Female