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Student Information

Name

First

Last

Email

Date of Birth

Cell Phone

Home Phone

Home Address

Address Line 1

City

State

Zip Code

High School Information

High School Name

High School Website

Year of Graduation

GPA weighted/Unweighted

Size of high school graduating class:

Parent Information

Parent #1

Name: Phone: Email:

Parent #2

Name: Phone: Email:

Part 1

Honors, IB and AP Courses:

Freshman Year

Sophomore Year

Junior Year

Senior Year

SAT/ACT- I will be submitting SAT or ACT

Yes
No

Part 2

Additional AP Courses to be taken listed here:

Community College or college courses taken:

Do you have an Academic resume?

Yes
No

Do you have an IEP?

Yes
No

College Considered

How many separate applications do you anticipate needing for the Fall of 2022

(include the Common Application, UC and CSU Applications, the Coalition Application, and individual schools’ applications such as those required by Georgetown and M.I.T.)?

I plan to attend in state public college or university only.

Yes
No

I plan to apply to both public and private colleges and universities.

Yes
No

Regions

Location

Possible Majors:

Possible Minors

Are you a scholar athlete?

Which sports do you play?

Music or Other Performance Talent:

Any Other Comments: