| * Required fields |
| Name *
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| E-mail Address *
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| APPLICATION DATE * |
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| LAST NAME * |
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| FIRST NAME * |
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| MALE/FEMALE * |
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| ETHINICITY (Optional) |
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| STREET ADDRESS * |
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| CITY/STATE * |
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| ZIP CODE * |
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| HOME PHONE * |
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| CELL PHONE |
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| BIRTHDATE * |
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| GRADUATION DATE * |
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| PARENT or GUARDIAN(S) NAMES: * |
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| NAME OF SCHOOL CURRENTLY ATTENDING? * |
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| WHAT TYPE OF SCHOOL? * |
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| SCHOOLS ADDRESS? * |
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| WHAT IS YOUR G.P.A. * |
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| TAKEN STANDARIZED TEST * |
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| IF TAKEN, WHAT WAS YOUR SCORE & DATE? |
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| DO YOU PLAY SPORTS? * |
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| IF SO, WHAT SPORT(S) |
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| LIST BELOW ACADEMIC HONORS OR ACHIEVEMENTS |
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| HAVE YOU APPLIED TO ANY COLLEGES? * |
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| IF YES, WHICH ONE(S)? |
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| WHAT WILL YOU MAJOR IN? * |
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| WHAT IS YOUR FAMILY'S INCOME? * |
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| WHAT IS YOUR FAMILY SIZE * |
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| HOW DO YOU PLAN TO PAY FOR COLLEGE? * |
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| HAVE YOU APPLIED FOR FINANCIAL AIDE (FAFSA) * |
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