First Name:
 

Last Name:
 

Middle Initial:
 

Email Address:
 

Phone:
 

Date of Birth:
 

Gender:

male  female

Street/PO Box:
 

City:
 

State:
 

      Zip:  
 

Country:
 

I will be a:
 

  Freshman Student     Transfer Student
 

OR 

top 5%   top 15%  top 25%  other

Highest Scores:

 SAT/PSAT Verbal

SAT/PSAT Math

ACT

TOEFL

School you attend now: 
 

School Location:
 

 City:   State:  
 

Year of H.S. Graduation:
 

Intended Major:
 

Choose one... Undecided Business Undecided Liberal Arts Undecided Science Accounting American Studies Biochemistry Biology* Chemistry Communication (includes Theatre Arts and Journalism) Computer Engineering Computer Science Criminal Justice Economics Education Studies** English Finance Fine Arts Foreign Languages Health Care Administration History International Studies Management Mangerial Economics Marketing Mathematics Medical Technology Multidisciplinary Studies Philosophy Political Science Psychology Public Administration Religious Studies Sociology
 * Please note Biology includes, Pre-Med., Pre-Dental, and Pre-Vet.
** Please note that Education Studies includes teacher certification in Early Childhood and/or Elementary Education.
 

Extra-Curricular Interests:
 

How would you describe yourself?

Comments/Questions: