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Student Information

Name *

First

Last

Email *

Date of Birth *

Cell Phone *

Home Phone

Home Address

Address Line 1

Address Line 2

City

State

Zip Code

High School Information

High School Name

High School Website

Year of Graduation

GPA weighted/Unweighted

Class Rank

Parent Information

Parent #1 Information

Name: Phone: Email:

Parent #2 Information

Name: Phone: Email:

Part 1

Honors, IB and AP Courses:

Freshman Year

Sophomore Year

Junior Year

Senior Year

PSAT 1 (give date & breakdown):

PSAT 2 (give date & breakdown):

SAT 1 (give date & breakdown):

SAT 2 (give date & breakdown):

ACT 1 Composite/Date:

ACT 2 Composite/Date:

Part 2

AP Course 1:

AP Course 1: Test Score: Year Taken:

AP Course 2:

AP Course 2: Test Score: Year Taken:

AP Course 3:

AP Course 3: Test Score: Year Taken:

AP Course 4:

AP Course 4: Test Score: Year Taken:

AP Course 5:

AP Course 5: Test Score: Year Taken:

Subject Test1 Score:

Subject Test1 Score: Date:

Subject Test2 Score: (copy)

Subject Test2 Score: Date:

Subject Test3 Score: (copy) (copy)

Subject Test3 Score: Date:

Subject Test4 Score: (copy) (copy) (copy)

Subject Test4 Score: Date:

College Considered

Regions

Location

Possible Majors:

Possible Minors

Are you a scholar athlete?

Sports

Music or Other Performance Talent:

Any Other Comments: