Information Request Form - First Year Students

Date: Planned Start Term:
Personal Information
Gender: Male Female
First Name:
Middle Initial:
Last Name:
Address:
City:
State:
Zip(Postal) Code:
Country:
Phone Number:
Email Address: *
Academic Information
High School:
Graduation Year:
H.S. GPA:
Class Rank: out of
ACT/SAT I Score:
Academic Interest(s):

Please list the high school activities that you participated in:

Band
Baseball
Basketball
Cheerleading
Choir		 Cross Country
Debate
Dramatics
Football
Golf		 Gymnastics
National Honor Society
Newspaper
Swimming
Softball		 Soccer
Speech
Student Government
Tennis
Track		 Volleyball
Wrestling
Writers' Group
Yearbook
Others
   
Please list any academic or extracurricular recognition, honors or awards you have received.
   

Please list the college activities you would like to participate in:

Baseball
Basketball
Cheerleading
Cross Country
Dance Team
Debate		 Environmental Club
Football
Golf
Greek Life
Instrumental Music
Intramurals		 Newspaper
Radio
Religious Life
Soccer
Softball		 Student Government
Swimming
Tennis
Theatre
Track		 Vocal Music
Volunteer/Services
Volleyball
Wrestling
Others