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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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