Graduation Year - 2010 2011 2012 2013 2014
First Name* Middle Name
Last Name* Preferred Name
Home Address*
City* , State* Zip*
Email*
Country
Home Phone Number* e.g. 123-456-7890
Cell Phonee.g. 123-456-7890
Birth Date* month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 - - 1991 1992 1993 1994 1995 1996 1997 Registered With Clearinghouse* chose yes no
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Family Information
Father's Name Father's Occupation
Father's Employer Father's Home Phone
Father's Work Phone Father's Cell Phone
Father's Email Father's College
Mother's Name Mother's Occupation
Mother's Employer Mother's Home Phone
Mother's Work Phone Mother's Cell Phone
Mother's Email Mother's College
I live with - dad mom
The names and ages of my siblings are
The best way to reach me is (choose one) Cell Home Email
Athletic Information
Notable Squash Results
Years of Experience
Height ft in Weight lb
Jersey Number Other Sports
My online video link is
Scholastic Information
High School Name
Street Address
City , State Zip
Country Phone e.g. 123-456-7890
Counselor
My academic interests are
Class Rank #/# G.P.A.
Club Team
Club Team Name
Address
City State Zip
Coach Name Office Phone
Cell Phone Email
General Information
My top priorities in choosing a college are:
1. 2. 3.
The students and alums I know are:
My favorite hobbies are:
The person that will help me chose a college is:
Cell phone:
The five schools I plan to visit are:
1. 2. 3. 4. 5.
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