Student Aid on the Web

Student Aid on the Web

Bullet 3_Applications

Student Aid on the Web

OMB: 1845-0076

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Question Name

Question

Numeric

Form Maxlength

Database Maxlength

Application Information
Y/N: Previously applied

Have you previously applied?

NO

1

Date previously applied

If Yes, when?

NO

7

4

Term last applied

Term:

NO

6

32

Year last applied

Year:

YES

Division previously applied

Division applied to:

NO

1

4

4

30

255

Y/N: Previously accepted

Were you accepted?

NO

1

1

enrolled/attend

Were you previously enrolled?

NO

1

1

Date previously attended

Date attended:

NO

7

4

from

Date attended from:

NO

7

4

Previously attended - date to

to:

NO

7

4

Term last attended

Term:

NO

6

32

Year last attended

Year:

YES

4

4

Division previously attended

Division previously attended:

NO

35

255

Transferable Units

Applying as a:

NO

32

32

Enrollment term

Enrollment term:

NO

5

12

Enrollment status

Enrollment status:

NO

1

1

Major 1 - undecided (1char)

Major undecided:

NO

1

1

Major 1 - name

Intended major:

NO

96

96

Major 2 - name

Alternate major:

NO

96

Major 3 - name

Alternate major:

NO

96

Major 4 - name

Alternate major:

NO

housing?

Interested in on-campus housing?

NO

1

1

Plan to live where / housing

I plan to live:

NO

40

255

aid?

Applying for financial aid?

NO

1

1

school?

school?

NO

1

1

Y/N: Visited the university?

Have you visited the University?

NO

1

1

96

High School Information
*High sch 1 enrolled - name

High school:

NO

30

48

*High sch 1 enrolled - type

Type:

NO

1

1

*High sch 1 enrolled - ceeb

CEEB code:

NO

7

7

*High sch 1 address - street

Street:

NO

35

48

*High sch 1 address - city

City:

NO

20

32

*High sch 1 address - state

State:

NO

2

2

NO

10

10

*High sch 1 address - zip code Zip code:
*High sch 1 address - country

Country:

NO

2

2

code

Int'l postal code:

NO

12

15

from

Date attended from:

NO

7

4

*High sch 1 enrolled - date to

to:

NO

7

4

date

Graduation date:

NO

7

4

leave

Reason for leaving:

NO

30

32

*Phone # - high school 1

Phone number:

NO

14

32

*Fax # - high school 1

Fax number:

NO

14

32

*High sch 2 enrolled - name

High school:

NO

30

48

*High sch 2 enrolled - type

Type:

NO

1

1

*High sch 2 enrolled - ceeb

CEEB code:

NO

7

7

*High sch 2 address - street

Street:

NO

35

48

*High sch 2 address - city

City:

NO

20

32

*High sch 2 address - state

State:

NO

2

2

NO

10

10

*High sch 2 address - zip code Zip code:
*High sch 2 address - country

Country:

NO

2

2

code

Int'l postal code:

NO

12

15

from

Date attended from:

NO

7

4

*High sch 2 enrolled - date to

to:

NO

7

4

date

Graduation date:

NO

7

4

leave

Reason for leaving:

NO

30

32

*Phone # - high school 2

Phone number:

NO

14

32

*High sch 3 enrolled - name

High school:

NO

30

48

*High sch 3 enrolled - type

Type:

NO

1

1

*High sch 3 enrolled - ceeb

CEEB code:

NO

7

7

*High sch 3 address - street

Street:

NO

35

48

*High sch 3 address - city

City:

NO

20

32

*High sch 3 address - state

State:

NO

2

2

NO

10

10

*High sch 3 address - zip code Zip code:
*High sch 3 address - country

Country:

NO

2

2

code

Int'l postal code:

NO

12

15

from

Date attended from:

NO

7

4

*High sch 3 enrolled - date to

to:

NO

7

4

date

Graduation date:

NO

7

4

leave

Reason for leaving:

NO

30

32

*Phone # - high school 3

Phone number:

NO

14

32

*High sch 4 enrolled - name

High school:

NO

30

48

*High sch 4 enrolled - type

Type:

NO

1

1

*High sch 4 enrolled - ceeb

CEEB code:

NO

7

7

*High sch 4 address - street

Street:

NO

35

48

*High sch 4 address - city

City:

NO

20

32

*High sch 4 address - state

State:

NO

2

2

*High sch 4 address - zip code Zip code:

NO

10

10

*High sch 4 address - country

Country:

NO

2

2

code

Int'l postal code:

NO

12

15

from

Date attended from:

NO

7

4

*High sch 4 enrolled - date to

to:

NO

7

4

date

Graduation date:

NO

7

4

leave

Reason for leaving:

NO

30

32

*High sch 5 enrolled - name

High school:

NO

30

48

*High sch 5 enrolled - type

Type:

NO

1

1

*High sch 5 enrolled - ceeb

CEEB code:

NO

7

7

*High sch 5 address - street

Street:

NO

35

48

*High sch 5 address - city

City:

NO

20

32

*High sch 5 address - state

State:

NO

2

2

NO

10

10

*High sch 5 address - zip code Zip code:
*High sch 5 address - country

Country:

NO

2

2

code

Int'l postal code:

NO

12

15

from

Date attended from:

NO

7

4

*High sch 5 enrolled - date to

to:

NO

7

4

date

Graduation date:

NO

7

4

leave

Reason for leaving:

NO

30

32

first

First name:

NO

20

32

last

Last name:

Additional High School Information
NO

25

32

*Phone # - college counselor 1 Phone number:

NO

14

32

1

Ext:

NO

6

6

*College counselor 1 - email

E-mail address:

NO

40

255

first

First name:

NO

20

32

last

Last name:

NO

25

32

*Phone # - college counselor 2 Phone number:

NO

14

32

*Y/N: Attempted GED

Attempted GED?

NO

1

1

*Y/N: Received GED

Received GED?

NO

1

1

7

*GED date

GED date:

NO

*GED state

GED state:

NO

4

*GED score

GED score:

NO

2

32

*High sch overall GPA

GPA:

YES

4

4

*High sch 1 - GPA (4.0 scale)

High sch 1 - GPA (4.0 scale):

YES

4

5

*High sch 2 - GPA (4.0 scale)

High sch 2 - GPA (4.0 scale):

YES

4

5

*High sch 3 - GPA (4.0 scale)

High sch 3 - GPA (4.0 scale):

YES

4

5

32

College Information
*College enrolled 1 - name

College/University:

NO

*College enrolled 1 - type

Type:

NO

10

36

code

CEEB code:

NO

7

7

*College 1 address - street

Street:

NO

35

48

*College 1 address - city

City:

NO

20

32

*College 1 address - state

State:

NO

2

2

*College 1 address - zip code

Zip code:

NO

10

10

*College 1 address - country

Country:

NO

2

2

*College 1 address - int'l code Int'l postal code:

NO

12

15

*College enrolled 1 - date from Date attended from:

NO

7

4

*College enrolled 1 - date to

to:

NO

7

4

*College enrolled 1 - units

Units completed:

YES

earned

Degree:

NO

12

3

5

12

32

*College enrolled 1 - deg date Degree date:

NO

7

4

leave

NO

30

32

Reason for leaving:

*College enrolled 2 - name

College/University:

NO

*College enrolled 2 - type

Type:

NO

10

code

CEEB code:

NO

7

7

*College 2 address - street

Street:

NO

35

48

*College 2 address - city

City:

NO

20

32

*College 2 address - state

State:

NO

2

2

*College 2 address - zip code

Zip code:

NO

10

10

*College 2 address - country

Country:

NO

2

2

NO

12

15

*College 2 address - int'l code Int'l postal code:

36
12

*College enrolled 2 - date from Date attended from:

NO

7

4

*College enrolled 2 - date to

to:

NO

7

4

*College enrolled 2 - units

Units completed:

YES

earned

Degree:

NO

3

5

12

32

*College enrolled 2 - deg date Degree date:

NO

7

4

leave

NO

30

32

Reason for leaving:

*College enrolled 3 - name

College/University:

NO

*College enrolled 3 - type

Type:

NO

10

code

CEEB code:

NO

7

7

*College 3 address - street

Street:

NO

35

48

*College 3 address - city

City:

NO

20

32

*College 3 address - state

State:

NO

2

2

*College 3 address - zip code

Zip code:

NO

10

10

*College 3 address - country

Country:

NO

2

2

NO

12

15

*College 3 address - int'l code Int'l postal code:

36
12

*College enrolled 3 - date from Date attended from:

NO

7

4

*College enrolled 3 - date to

to:

NO

7

4

*College enrolled 3 - units

Units completed:

YES

earned

Degree:

NO

3

5

12

32

*College enrolled 3 - deg date Degree date:

NO

7

4

leave

NO

30

32

Reason for leaving:

*College enrolled 4 - name

College/University:

NO

*College enrolled 4 - type

Type:

NO

10

code

CEEB code:

NO

7

7

*College 4 address - street

Street:

NO

35

48

*College 4 address - city

City:

NO

20

32

*College 4 address - state

State:

NO

2

2

*College 4 address - zip code

Zip code:

NO

10

10

*College 4 address - country

Country:

NO

2

2

NO

12

15

*College 4 address - int'l code Int'l postal code:

36
12

*College enrolled 4 - date from Date attended from:

NO

7

4

*College enrolled 4 - date to

to:

NO

7

4

*College enrolled 4 - units

Units completed:

YES

3

5

earned

NO

12

*College enrolled 4 - deg date Degree date:

Degree:

NO

7

4

leave

NO

30

32

Reasons for leaving:

32

*College enrolled 5 - name

College/University:

NO

*College enrolled 5 - type

Type:

NO

10

code

CEEB code:

NO

7

7

*College 5 address - street

Street:

NO

35

48

*College 5 address - city

City:

NO

20

32

*College 5 address - state

State:

NO

2

2

*College 5 address - zip code

Zip code:

NO

10

10

*College 5 address - country

Country:

NO

2

2

NO

12

15

*College 5 address - int'l code Int'l postal code:

36
12

*College enrolled 5 - date from Date attended from:

NO

7

4

*College enrolled 5 - date to

to:

NO

7

4

*College enrolled 5 - units

Units completed:

YES

earned

Degree:

NO

3

5

12

32

*College enrolled 5 - deg date Degree date:

NO

7

4

leave

Reasons for leaving:

NO

30

32

ACT

Have you taken the SAT I or ACT?

NO

1

1

ACT

Test date:

NO

7

4

ACT

Test date:

NO

7

4

*Y/N: Test planned - SAT I

Do you plan to take the SAT I?

NO

1

1

*Y/N: Test taken - SAT I

Have you taken the SAT I?

NO

1

1

*Test - SAT I 1 date

Date:

NO

7

4

*Test - SAT I 1 verbal score

Verbal:

YES

3

4

*Test - SAT I 1 math score

Math:

YES

3

4

*Test - SAT I 1 total score

Total:

YES

4

4

*Test - SAT I 2 date

Date:

NO

7

4

*Test - SAT I 2 verbal score

Verbal:

YES

3

4

*Test - SAT I 2 math score

Math:

YES

3

4

*Test - SAT I 2 total score

Total:

YES

4

4

*Test - SAT I 3 date

Date:

NO

7

4

*Test - SAT I 3 verbal score

Verbal:

YES

3

4

*Test - SAT I 3 math score

Math:

YES

3

4

*Test - SAT I 3 total score

Total:

YES

4

4

*Y/N: Test planned - SAT II

Do you plan to take the SAT II?

NO

1

1

*Y/N: Test taken - SAT II

Have you taken the SAT II?

NO

1

1

Standardized Tests

*Test - SAT II 1 date

Date:

NO

7

4

*Test - SAT II 1 subject

Subject:

NO

20

32

*Test - SAT II 1 score

Score:

YES

3

4

*Test - SAT II 2 date

Date:

NO

7

4

*Test - SAT II 2 subject

Subject:

NO

20

32

*Test - SAT II 2 score

Score:

YES

3

4

*Test - SAT II 3 date

Date:

NO

7

4

*Test - SAT II 3 subject

Subject:

NO

20

32

*Test - SAT II 3 score

Score:

YES

3

4

*Test - SAT II 4 date

Date:

NO

7

4

*Test - SAT II 4 subject

Subject:

NO

20

32

*Test - SAT II 4 score

Score:

YES

3

4

*Test - SAT II 5 date

Date:

NO

7

4

*Test - SAT II 5 subject

Subject:

NO

20

32

*Test - SAT II 5 score

Score:

YES

3

4

*Test - SAT II 6 date

Date:

NO

7

4

*Test - SAT II 6 subject

Subject:

NO

20

32

*Test - SAT II 6 score

Score:

YES

3

4

*Y/N: Test planned - ACT

Do you plan to take the ACT?

NO

1

1

*Y/N: Test taken - ACT

Have you taken the ACT?

NO

1

1

*Test - ACT 1 date

Date:

NO

7

4

*Test - ACT 1 english score

English:

YES

2

4

*Test - ACT 1 math score

Math:

YES

2

4

*Test - ACT 1 reading score

Reading:

YES

2

4

*Test - ACT 1 science score

Science:

YES

2

4

*Test - ACT 1 composite/total

Composite:

YES

2

4

*Test - ACT 2 date

Date:

NO

7

4

*Test - ACT 2 english score

English:

YES

2

4

*Test - ACT 2 math score

Math:

YES

2

4

*Test - ACT 2 reading score

Reading:

YES

2

4

*Test - ACT 2 science score

Science:

YES

2

4

*Test - ACT 2 composite/total

Composite:

YES

2

4

*Test - ACT 3 date

Date:

NO

7

4

*Test - ACT 3 composite/total

Composite:

YES

2

4

*Y/N: Test planned - TOEFL

Do you plan to take the TOEFL?

NO

1

1

*Y/N: Test taken - TOEFL

Have you taken the TOEFL?

NO

1

1

*Test - TOEFL 1 date

Date:

NO

7

4

*Test - TOEFL 1 total score

Total score:

YES

3

4

*Test - TOEFL 2 date

Date:

NO

7

4

*Test - TOEFL 2 total score

Total score:

YES

3

4

*Test - TOEFL 3 date

Date:

NO

7

4

*Test - TOEFL 3 total score

Total score:

YES

3

4

NO

1

1

*Y/N: Test - Taken AP or CLEP test?
*Test - AP 1 date

Date:

NO

7

4

*Test - AP 1 subject

Subject:

NO

20

32

*Test - AP 1 score

Score:

YES

1

4

*Test - AP 2 date

Date:

NO

7

4

*Test - AP 2 subject

Subject:

NO

20

32

*Test - AP 2 score

Score:

YES

1

4

*Test - AP 3 date

Date:

NO

7

4

*Test - AP 3 subject

Subject:

NO

20

32

*Test - AP 3 score

Score:

YES

1

4

*Test - AP 4 date

Date:

NO

7

4

*Test - AP 4 subject

Subject:

NO

20

32

*Test - AP 4 score

Score:

YES

1

4

*Test - AP 5 date

Date:

NO

7

4

*Test - AP 5 subject

Subject:

NO

20

32

*Test - AP 5 score

Score:

1

4

YES

Parents
*Father name - first

First name:

NO

20

32

*Father name - middle

Middle name:

NO

20

32

*Father name - middle initial

Middle initial:

NO

1

1

*Father name - last

Last name:

NO

25

32

*Father info - living?

Living?

NO

1

1

*Father info - deceased year

Year deceased:

YES

4

4

*Father info - age

Age:

YES

3

1

*Father address - street

Street:

NO

35

48

*Father address - city

City:

NO

20

32

*Father address - state

State:

NO

2

2

*Father address - zip code

Zip code:

NO

10

10

*Father address - country

Country:

NO

2

2

*Father address - Int'l code

Int'l postal code:

NO

12

15

*Phone # - father home

Phone number:

NO

14

32

*Phone # - father fax

Fax number:

NO

14

32

*Father info - occupation

Occupation:

NO

20

32

*Father info - occupation title

Title:

NO

20

32

*Father info - employer

Employer:

NO

20

32

street

Street:

NO

35

48

city

City:

NO

20

state

State:

NO

2

2

NO

10

10

*Father employer address - zip Zip code:

32

country

Country:

NO

2

2

intl

Int'l postal code:

NO

12

15

*Phone # - father work

Phone number:

NO

14

32

*Father college 1 - name

College 1:

NO

30

36

earned

Degree earned:

NO

20

32

date

Degree date:

NO

7

4

year

Year earned:

YES

4

4

*Father college 2 - name

College 2:

NO

30

36

earned

Degree earned:

NO

20

32

date

Degree date:

NO

7

4

year

Year earned:

YES

4

4

*Father college 3 - name

College 3:

NO

30

36

earned

Degree earned:

NO

20

32

date

Degree date:

NO

7

4

year

Year earned:

YES

4

4

*Mother name - first

First name:

NO

20

32

*Mother name - middle

Middle name:

NO

20

32

*Mother name - middle initial

Middle initial:

NO

1

1

*Mother name - last

Last name:

NO

25

32

*Mother name - maiden

Maiden name:

NO

25

32

*Mother info - living?

Living?

NO

1

1

*Mother info - deceased year

Year deceased:

YES

4

4

*Mother info - age

Age:

YES

3

1

*Mother address - street

Street:

NO

35

48

*Mother address - city

City:

NO

20

32

*Mother address - state

State:

NO

2

2

*Mother address - zip code

Zip code:

NO

10

10

*Mother address - country

Country:

NO

2

2

*Mother address - int'l code

Int'l postal code:

NO

12

15

*Phone # - mother home

Phone number:

NO

14

32

*Phone # - mother fax

Fax number:

NO

14

32

*Mother info - occupation

Occupation:

NO

20

32

*Mother info - occupation title Title:

NO

20

32

*Mother info - employer

Employer:

NO

20

32

street

Street:

NO

35

48

city

City:

NO

20

32

state

State:

NO

2

2

zip

Zip code:

NO

10

10

country

Country:

NO

2

2

intl

Int'l postal code:

NO

12

15

*Phone # - mother work

Phone number:

NO

14

32

*Mother college 1 - name

College 1:

NO

30

36

earned

Degree earned:

NO

20

32

date

Degree date:

NO

7

4

year

Year earned:

YES

4

4

*Mother college 2 - name

College 2:

NO

30

36

earned

Degree earned:

NO

20

32

date

Degree date:

NO

7

4

year

Year earned:

YES

4

4

*Mother college 3 - name

College 3:

NO

30

36

earned

Degree earned:

NO

20

32

date

Degree date:

NO

7

4

year

Year earned:

YES

4

4

20

32

Spouse
*Spouse name - first

First name:

NO

*Spouse name - middle

Middle name:

NO

20

*Spouse name - middle initial

Middle initial:

NO

1

32
1

*Spouse name - last

Last name:

NO

25

32

*Spouse name - maiden

Maiden name:

NO

25

32

*Spouse info - living?

Living?

NO

1

1

*Spouse info - age

Age:

YES

3

1

*Spouse address - street

Street:

NO

35

48

*Spouse address - city

City:

NO

20

32

*Spouse address - state

State:

NO

2

2

*Spouse address - zip code

Zip code:

NO

10

10

*Spouse address - country

Country:

NO

2

2

*Spouse address - int'l code

Int'l postal code:

NO

12

15

*Phone # - spouse

Phone number:

NO

14

32

*Spouse info - occupation

Occupation:

NO

20

32

positn

Position:

NO

20

32

*Spouse info - occupation title Title:

NO

20

32

*Spouse info - employer

Employer:

NO

20

32

street

Street:

NO

35

48

*Spouse employer addrs - city City:

NO

20

32

state

NO

2

2
10

State:

*Spouse employer addrs - zip

Zip code:

NO

10

country

Country:

NO

2

2

cd

Int'l postal code:

NO

12

15

*Phone # - Spouse work

Phone number:

NO

14

32

*Spouse college - name

College:

NO

30

36

earned

Degree:

NO

12

32

Siblings
*Sibling name 1 - first

First name:

NO

20

32

*Sibling name 1 - middle

Middle name:

NO

20

32

initial

Middle initial:

NO

1

1

*Sibling name 1 - last

Last name:

NO

25

32

*Sibling 1 - age

Age:

YES

2

4

*Sibling 1 - grad year

Graduation year:

YES

4

4

*Sibling name 1 - institution

Institution:

NO

30

32

*Sibling 1 college - date from

Date attended from:

NO

7

4

*Sibling 1 college - date to

to:

NO

7

4

*Sibling 1 - degree

Degree earned:

NO

20

32

*Sibling 1 - degree date

Degree date:

NO

7

4

*Sibling name 2 - first

First name:

NO

20

32
32

*Sibling name 2 - middle

Middle name:

NO

20

initial

Middle initial:

NO

1

1

*Sibling name 2 - last

Last name:

NO

25

32

*Sibling 2 - age

Age:

YES

2

4

*Sibling 2 - grad year

Graduation year:

YES

4

4

*Sibling name 2 - institution

Institution:

NO

30

32

*Sibling 2 college - date from

Date attended from:

NO

7

4

*Sibling 2 college - date to

to:

NO

7

4

*Sibling 2 - degree

Degree earned:

NO

20

32

*Sibling 2 - degree date

Degree date:

NO

7

4

*Sibling name 3 - first

First name:

NO

20

32
32

*Sibling name 3 - middle

Middle name:

NO

20

initial

Middle initial:

NO

1

1

*Sibling name 3 - last

Last name:

NO

25

32

*Sibling 3 - age

Age:

YES

2

4

*Sibling 3 - grad year

Graduation year:

YES

4

4

*Sibling name 3 - institution

Institution:

NO

30

32

*Sibling 3 college - date from

Date attended from:

NO

7

4

*Sibling 3 college - date to

to:

NO

7

4

*Sibling 3 - degree

Degree earned:

NO

20

*Sibling 3 - degree date

Degree date:

NO

7

32
4

*Sibling name 4 - first

First name:

NO

20

32
32

*Sibling name 4 - middle

Middle name:

NO

20

initial

Middle initial:

NO

1

1

*Sibling name 4 - last

Last name:

NO

25

32

*Sibling 4 - age

Age:

YES

2

4

*Sibling 4 - grad year

Graduation year:

YES

4

4

*Sibling name 4 - institution

Institution:

NO

30

32

*Sibling 4 college - date from

Date attended from:

NO

7

4

*Sibling 4 college - date to

to:

NO

7

4

*Sibling 4 - degree

Degree earned:

NO

20

32

*Sibling 4 - degree date

Degree date:

NO

7

4

*Sibling name 5 - first

First name:

NO

20

32
32

*Sibling name 5 - middle

Middle name:

NO

20

initial

Middle initial:

NO

1

1

*Sibling name 5 - last

Last name:

NO

25

32

*Sibling 5 - age

Age:

YES

2

4

*Sibling 5 - grad year

Graduation year:

YES

4

4

*Sibling name 5 - institution

Institution:

NO

30

32

*Sibling 5 college - date from

Date attended from:

NO

7

4

*Sibling 5 college - date to

to:

NO

7

4

*Sibling 5 - degree

Degree earned:

NO

20

32

*Sibling 5 - degree date

Degree date:

NO

7

4
32

Other Relatives/Contacts
Relative 1 name - first

First name:

NO

20

Relative 1 name - last

Last name:

NO

25

32

Relative 1 - relationship

Relationship:

NO

20

32

Relative 1 - class/year

Class/Year:

NO

4

32

Relative 2 name - first

First name:

NO

20

32

Relative 2 name - last

Last name:

NO

25

32

Relative 2 - relationship

Relationship:

NO

20

32

Relative 2 - class/year

Class/Year:

NO

4

32

Relative 3 name - first

First name:

NO

20

32

Relative 3 name - last

Last name:

NO

25

32

Relative 3 - relationship

Relationship:

NO

20

32

Relative 3 - class/year

Class/Year:

NO

4

32

Relative 4 name - first

First name:

NO

20

32

Relative 4 name - last

Last name:

NO

25

32

Relative 4 - relationship

Relationship:

NO

20

32

Relative 4 - class/year

Class/Year:

NO

4

32

*Academic ref 1 - first name

First name:

NO

20

32

*Academic ref 1 - last name

Last name:

NO

25

32

street

Street:

NO

35

48

*Academic ref. 1 address - city City:

NO

20

32

state

NO

2

2

*Academic ref. 1 address - zip Zip code:

NO

10

10

country

State:

NO

2

2

*Academic ref. 1 address - int'l Int'l postal code:

Country:

NO

12

15

*Phone # - Academic ref 1

Phone number:

NO

14

32

*Academic ref 2 - first name

First name:

NO

20

32

*Academic ref 2 - last name

Last name:

NO

25

32

street

Street:

NO

35

48

*Academic ref. 2 address - city City:

NO

20

32

state

NO

2

2

*Academic ref. 2 address - zip Zip code:

NO

10

10

country

NO

2

2

NO

12

15

State:
Country:

*Academic ref. 2 address - int'l Int'l postal code:

*Phone # - Academic ref 2

Phone number:

NO

14

32

name

First name:

NO

20

32

*Financially respon - last name Last name:

NO

25

32

relationshp

NO

20

32

Relationship:

*Financially respon - street

Street:

NO

35

48

*Financially respon - city

City:

NO

20

32

*Financially respon - state

State:

NO

2

2

*Financially respon - zip code

Zip code:

NO

10

10

*Financially respon - country

Country:

NO

2

2

*Financially respon - intl code

Int'l postal code:

NO

12

15

*Phone # - Financially respon

Phone number:

NO

14

32

first

First name:

NO

20

32

*Emergency contact name-last Last name:

NO

25

32

*Emergency contact - street

Street:

NO

35

48

*Emergency contact - city

City:

NO

20

32

*Emergency contact - state

State:

NO

2

2

*Emergency contact - zip code Zip code:

NO

10

10

*Emergency contact - country Country:

NO

2

2

*Emergency contact - intl code Int'l postal code:

NO

12

15

day

Daytime phone number:

NO

14

32

evening

Evening telephone number:

NO

14

32
32

High School Activities
*Activity 1 - name

Activity:

NO

20

*Activity 1 - date from

Date from:

NO

7

4

*Activity 1 - date to

to:

NO

7

4

*Activity 1 - active 9th grd

9th:

NO

1

1

*Activity 1 - active 10th grd

10th:

NO

1

1

*Activity 1 - active 11th grd

11th:

NO

1

1

*Activity 1 - active 12th grd

12th:

NO

1

1

sec

Post-secondary:

NO

1

1

*Activity 1 - hours per week

Hours per week:

YES

2

1

*Activity 1 - weeks per year

Weeks per year:

YES

2

1

20

32

*Activity 1 - position or honors Position/Honors:

NO

*Activity 1 - Continue in col?

Continue?

NO

1

1

*Activity 2 - name

Activity:

NO

20

32

*Activity 2 - date from

Date from:

NO

7

4

*Activity 2 - date to

to:

NO

7

4

*Activity 2 - active 9th grd

9th:

NO

1

1

*Activity 2 - active 10th grd

10th:

NO

1

1

*Activity 2 - active 11th grd

11th:

NO

1

1

*Activity 2 - active 12th grd

12th:

NO

1

1

sec

Post-secondary:

NO

1

1

*Activity 2 - hours per week

Hours per week:

YES

2

1

*Activity 2 - weeks per year

Weeks per year:

YES

2

1

20

32

*Activity 2 - position or honors Position/Honors:

NO

*Activity 2 - Continue in col?

Continue?

NO

1

1

*Activity 3 - name

Activity:

NO

20

32

*Activity 3 - date from

Date from:

NO

7

4

*Activity 3 - date to

to:

NO

7

4

*Activity 3 - active 9th grd

9th:

NO

1

1

*Activity 3 - active 10th grd

10th:

NO

1

1

*Activity 3 - active 11th grd

11th:

NO

1

1

*Activity 3 - active 12th grd

12th:

NO

1

1

sec

Post-secondary:

NO

1

1

*Activity 3 - hours per week

Hours per week:

YES

2

1

*Activity 3 - weeks per year

Weeks per year:

YES

2

1

*Activity 3 - position or honors Position/Honors:

NO

20

32

*Activity 3 - Continue in col?

NO

1

1

Continue?

*Activity 4 - name

Activity:

NO

20

*Activity 4 - date from

Date from:

NO

7

4

*Activity 4 - date to

to:

NO

7

4

*Activity 4 - active 9th grd

9th:

NO

1

1

*Activity 4 - active 10th grd

10th:

NO

1

1

*Activity 4 - active 11th grd

11th:

NO

1

1

*Activity 4 - active 12th grd

12th:

NO

1

1

sec

Post-secondary:

NO

1

1

*Activity 4 - hours per week

Hours per week:

YES

2

1

*Activity 4 - weeks per year

Weeks per year:

YES

32

2

1

20

32

*Activity 4 - position or honors Position/Honors:

NO

*Activity 4 - Continue in col?

Continue?

NO

1

1

*Activity 5 - name

Activity:

NO

20

32

*Activity 5 - date from

Date from:

NO

7

4

*Activity 5 - date to

to:

NO

7

4

*Activity 5 - active 9th grd

9th:

NO

1

1

*Activity 5 - active 10th grd

10th:

NO

1

1

*Activity 5 - active 11th grd

11th:

NO

1

1

*Activity 5 - active 12th grd

12th:

NO

1

1

sec

Post-secondary:

NO

1

1

*Activity 5 - hours per week

Hours per week:

YES

2

1

*Activity 5 - weeks per year

Weeks per year:

YES

2

1

20

32

*Activity 5 - position or honors Position/Honors:

NO

*Activity 5 - Continue in col?

Continue?

NO

1

1

*Activity 6 - name

Activity:

NO

20

32

*Activity 6 - date from

Date from:

NO

7

4

*Activity 6 - date to

to:

NO

7

4

*Activity 6 - active 9th grd

9th:

NO

1

1

*Activity 6 - active 10th grd

10th:

NO

1

1

*Activity 6 - active 11th grd

11th:

NO

1

1

*Activity 6 - active 12th grd

12th:

NO

1

1

sec

Post-secondary:

NO

1

1

*Activity 6 - hours per week

Hours per week:

YES

2

1

*Activity 6 - weeks per year

Weeks per year:

YES

2

1

20

32

*Activity 6 - position or honors Position/Honors:

NO

*Activity 6 - Continue in col?

Continue?

NO

1

1

*Activity 7 - name

Activity:

NO

20

32

*Activity 7 - date from

Date from:

NO

7

4

*Activity 7 - date to

to:

NO

7

4

*Activity 7 - active 9th grd

9th:

NO

1

1

*Activity 7 - active 10th grd

10th:

NO

1

1

*Activity 7 - active 11th grd

11th:

NO

1

1

*Activity 7 - active 12th grd

12th:

NO

1

1

sec

Post-secondary:

NO

1

1

*Activity 7 - hours per week

Hours per week:

YES

2

1

*Activity 7 - weeks per year

Weeks per year:

YES

2

1

20

32

*Activity 7 - position or honors Position/Honors:

NO

*Activity 7 - Continue in col?

Continue?

NO

1

1

*Activity 8 - name

Activity:

NO

20

32

*Activity 8 - date from

Date from:

NO

7

4

*Activity 8 - date to

to:

NO

7

4

*Activity 8 - active 9th grd

9th:

NO

1

1

*Activity 8 - active 10th grd

10th:

NO

1

1

*Activity 8 - active 11th grd

11th:

NO

1

1

*Activity 8 - active 12th grd

12th:

NO

1

1

sec

Post-secondary:

NO

1

1

*Activity 8 - hours per week

Hours per week:

YES

2

1

*Activity 8 - weeks per year

Weeks per year:

YES

2

1

*Activity 8 - position or honors Position/Honors:

NO

20

*Activity 8 - Continue in col?

Continue?

NO

1

32
1

*Activity 9 - name

Activity:

NO

20

32

*Activity 9 - date from

Date from:

NO

7

4

*Activity 9 - date to

to:

NO

7

4

*Activity 9 - active 9th grd

9th:

NO

1

1

*Activity 9 - active 10th grd

10th:

NO

1

1

*Activity 9 - active 11th grd

11th:

NO

1

1

*Activity 9 - active 12th grd

12th:

NO

1

1

sec

Post-secondary:

NO

1

1

*Activity 9 - hours per week

Hours per week:

YES

2

1

*Activity 9 - weeks per year

Weeks per year:

YES

2

1

NO

20

32

NO

1

1
32

*Activity 9 - position or honors Position/Honors:
*Activity 9 - Continue in col?

Continue?

Employment/Work
*Phone # - current work

Work phone number:

NO

14

*Work 1 - nature of work

Nature of work:

NO

30

72

*Work 1 - employer name

Employer:

NO

25

32

*Work 1 - position

Position:

NO

20

32

*Work 1 - address street

Street:

NO

35

48

*Work 1 - address city

City:

NO

20

32

*Work 1 - address state

State:

NO

2

2

*Work 1 - address - zip code

Zip code:

NO

10

10

*Work 1 - address - country

Country:

NO

2

2

*Work 1 - address - intl code

Int'l postal code:

NO

12

15

*Work 1 - date from

Date from:

NO

7

4

*Work 1 - date to

to:

NO

7

4

*Work 1 - hours per week

Hours per week:

YES

2

1

*Work 1 - weeks per year

Weeks per year:

YES

2

1

*Work 1 - continue in college

Continue?

NO

1

1

*Phone # - work 1

Phone number:

NO

14

32

*Phone # - work 1 fax

Fax number:

NO

14

32

*Work 2 - nature of work

Nature of work:

NO

30

72

*Work 2 - employer name

Employer:

NO

25

32

*Work 2 - position

Position:

NO

20

32

*Work 2 - date from

Date from:

NO

7

4

*Work 2 - date to

to:

NO

7

4

*Work 2 - hours per week

Hours per week:

YES

2

1

*Work 2 - weeks per year

Weeks per year:

YES

2

1

*Work 2 - continue in college

Continue?

NO

1

1

*Phone # - work 2

Phone number:

NO

14

32

*Work 3 - nature of work

Nature of work:

NO

30

72

*Work 3 - employer name

Employer:

NO

25

32

*Work 3 - position

Position:

NO

20

32

*Work 3 - date from

Date from:

NO

7

4

*Work 3 - date to

to:

NO

7

4

*Work 3 - hours per week

Hours per week:

YES

2

1

*Work 3 - weeks per year

Weeks per year:

YES

2

1

*Work 3 - continue in college

Continue?

NO

1

1

*Phone # - work 3

Phone number:

NO

14

32

*Work 4 - nature of work

Nature of work:

NO

30

72

*Work 4 - employer name

Employer:

NO

25

32

*Work 4 - position

Position:

NO

20

32

*Work 4 - date from

Date from:

NO

7

4

*Work 4 - date to

to:

NO

7

4

*Work 4 - hours per week

Hours per week:

YES

2

1

*Work 4 - weeks per year

Weeks per year:

YES

2

1

*Work 4 - continue in college

Continue?

NO

1

1

*Phone # - work 4

Phone number:

NO

14

*Work 5 - nature of work

Nature of work:

NO

30

32
72

*Work 5 - employer name

Employer:

NO

25

32

*Work 5 - position

Position:

NO

20

32

*Work 5 - date from

Date from:

NO

7

4

*Work 5 - date to

to:

NO

7

4

*Work 5 - hours per week

Hours per week:

YES

2

1

*Work 5 - weeks per year

Weeks per year:

YES

2

1

*Work 5 - continue in college

Continue?

NO

1

1

*Phone # - work 5

Phone number:

NO

14

32

Current/Planned Coursework
*Col course InProg 1 - title

Title:

NO

26

48

department

Department:

NO

8

32

*Col course InProg 1 - number Number:

NO

5

6

*Col course InProg 1 - credits

Credits:

YES

3

5

type

Term type:

NO

1

1

*Col course InProg 2 - title

Title:

NO

26

48

department

Department:

32

NO

8

*Col course InProg 2 - number Number:

NO

5

6

*Col course InProg 2 - credits

Credits:

YES

3

5

type

Term type:

NO

1

1

*Col course InProg 3 - title

Title:

NO

26

48

department

Department:

32

NO

8

*Col course InProg 3 - number Number:

NO

5

6

*Col course InProg 3 - credits

Credits:

YES

3

5

type

Term type:

NO

1

1

*Col course InProg 4 - title

Title:

NO

26

48

department

Department:

32

NO

8

*Col course InProg 4 - number Number:

NO

5

6

*Col course InProg 4 - credits

Credits:

YES

3

5

type

Term type:

NO

1

1

*Col course InProg 5 - title

Title:

NO

26

48

department

Department:

NO

8

32

*Col course InProg 5 - number Number:

NO

5

6

*Col course InProg 5 - credits

Credits:

YES

3

5

type

Term type:

NO

1

1

*Col course InProg 6 - title

Title:

NO

26

48

department

Department:

32

NO

8

*Col course InProg 6 - number Number:

NO

5

6

*Col course InProg 6 - credits

Credits:

YES

3

5

type

Term type:

NO

1

1

*Col course InProg 7 - title

Title:

NO

26

48

department

Department:

32

NO

8

*Col course InProg 7 - number Number:

NO

5

6

*Col course InProg 7 - credits

Credits:

YES

3

5

type

Term type:

NO

1

1

*Col course Plan 1 - title

Title:

NO

26

48

department

Department:

NO

8

32

*Col course Plan 1 - number

Number:

NO

5

6

*Col course Plan 1 - credits

Credits:

YES

4

5

*Col course Plan 1 - term type Term type:

NO

1

1

*Col course Plan 2 - title

Title:

NO

26

48

department

Department:

NO

8

32

*Col course Plan 2 - number

Number:

NO

5

6

*Col course Plan 2 - credits

Credits:

YES

4

5

*Col course Plan 2 - term type Term type:

NO

1

1

*Col course Plan 3 - title

Title:

NO

26

48

department

Department:

NO

8

32

*Col course Plan 3 - number

Number:

NO

5

6

*Col course Plan 3 - credits

Credits:

YES

4

5

*Col course Plan 3 - term type Term type:

NO

1

1

*Col course Plan 4 - title

Title:

NO

26

48

department

Department:

NO

8

32

*Col course Plan 4 - number

Number:

NO

5

6

*Col course Plan 4 - credits

Credits:

YES

4

5

*Col course Plan 4 - term type Term type:

NO

1

1

*Col course Plan 5 - title

Title:

NO

26

48

department

Department:

NO

8

32

*Col course Plan 5 - number

Number:

NO

5

6

*Col course Plan 5 - credits

Credits:

YES

4

5

*Col course Plan 5 - term type Term type:

NO

1

1

*Col course Plan 6 - title

Title:

NO

26

48

department

Department:

NO

8

32

*Col course Plan 6 - number

Number:

NO

5

6

*Col course Plan 6 - credits

Credits:

YES

4

5

*Col course Plan 6 - term type Term type:

NO

1

1

*Col course Plan 7 - title

Title:

NO

26

48

department

Department:

NO

8

32

*Col course Plan 7 - number

Number:

NO

5

6

*Col course Plan 7 - credits

Credits:

YES

3

5

NO

1

1

*Col course Plan 7 - term type Term type:


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File Title3F54B8C9-1870-089801.xls
Authorwww
File Modified2003-09-02
File Created2003-09-02

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