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* 1. First Name:

* 2. Last Name:

3. Date of Birth:

4. Age:

6. Race:

7. Citizenship:

8. Address:

9. Phone Number where you can best be reached:

10. E-mail Address:

11. High School Attended, City, State:

12. Height in inches:

13. Weight in pounds:

15. Have you ever ran 1.5 miles? If so, what was your time?

16. Can you swim 50 yards without stopping?

17. High School GPA:

18. Class Rank (ex. 25 of 400):

19. Graduation Date (MM/YYYY):

20. SAT/ACT Composite Score:

21. SAT/ACT Math:

22. SAT/ACT Verbal:

23. If you participated in JROTC, what what the highest billet you held?

24. Please list any extracurricular activities you are involved in:

25. If you are enrolled in college what is your current GPA?

26. Please list the most advanced MATH and SCIENCE courses you completed in HIGH SCHOOL:

27. If you are enrolled in COLLEGE, please list the most advanced MATH and SCIENCE courses you have completed:

28. Which university are you interested in attending?

30. Please list any medical issues that may prevent you from military service:

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