PERSONAL INFORMATION

Name:Sex: female male

Home Address:

City:State: AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV ZIP Code:

Home Phone:E-mail:

Fax:Birthdate:

Parent/Guardian Names:

Parents' Occupation:

SCHOLASTIC INFORMATION

High School:Graduation Date:

City:State: AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV ZIP Code:

School Phone:School Fax:

GPA:ACT/SAT Score:Dates Taken:

Class Rank:ofGuidance Counselor:

Registered with Clearinghouse?Yes No Intended Major:

Who do you know attending/attended The University of Akron?

ATHLETIC INFORMATION

Height:Weight:Club Team:

Events:

Best Marks:

Athletic Honors/Awards:

Other Sports:

Coach's Name:Phone:

Club Coach's Name:Phone: