NAME: _________________________________________________________________________________________ ADDRESS: _____________________________________ CITY: _____________________ STATE ____ ZIP________ HOME PHONE: (____________)_____________________ CELL PHONE: (____________)_____________________ E-MAIL: ________________________________________ FATHER’S NAME: _______________________________ MOTHER’S NAME: _____________________________ FATHER’S OCCUPATION: _________________________ MOTHER’S OCCUPATION: _______________________ ARE YOU INTERESTED IN ROTC? ___YES ___ NO - ARE YOU A MILITARY DEPENDENT? ____YES ___ NO ACADEMIC BACKGROUND HIGH SCHOOL: __________________________________ GRADUATION YEAR: ___________________________ HIGH SCHOOL ADDRESS: ________________________________________________________________________ HEAD COACH: __________________________________ COACH’S #: (____________)______________________ GPA: ________/4.0 CLASS RANK: ________/ ________ ACADEMIC HONORS: ___________________________ SAT: COMPOSITE : ________ SAT - (VERBAL) ________ SAT - (MATH) _________ SAT - (WRITTEN) _________ ACT: COMPOSITE ________ MATH _________ ENGLISH _________ READING _________ SCIENCE _________ ACADEMIC INTEREST IN COLLEGE: 1. _____________________________ 2. _____________________________ OTHER COLLEGES OF INTEREST: 1. _____________________________