NAME OF APPLICANT:________________________________________________________

ADDRESS OF APPLICANT:_____________________________________________________

NAME OF HIGH SCHOOL:______________________________________________________

ADDRESS OF SCHOOL:________________________________________________________

TELEPHONE NUMBER:___________________________

APPLICANT'S YEAR IN SCHOOL:_______

NUMERICAL JUNIOR YEAR CLASS RANK _______

G.P.A.________

SAT SCORES: Verbal:________________ Math:___________________

ACT SCORES: English:_______________ Math:___________________

LEADERSHIP CHARACTERISTICS:_______________________________________________

__________________________________________________________________________

PERSONALITY TRAITS:_______________________________________________________

__________________________________________________________________________

ABILITY TO WORK UNDER PRESSURE:___________________________________________

ABILITY TO GET ALONG WITH OTHERS:_________________________________________

LIST SCHOOL ACTIVITIES IN WHICH APPLICANT PARTICIPATES:___________________

__________________________________________________________________________

__________________________________________________________________________

GENERAL COMMENTS/RECOMMENDATION (Your comments are most helpful, so please

complete this section):________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

DATE:________________________SIGNATURE:__________________________

POSITION: __________________________

PLEASE SEND THIS FORM AND A TRANSCRIPT SHOWING FINAL JUNIOR GRADES.