| Personal Information |
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| Date of Birth |
Sex |
Ethnic Background |
Family Size in Household |
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Do You Have Any Dependents |
How Many? |
Do Receive Free Lunch at School? |
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| Education |
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| List Clubs or other Extracurricular Activities |
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| Is there anyone in your family who has graduated or is now attending a 4-year college/university? |
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| If yes what is their relationship to you? |
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| Emergency Parental/Contact Information |
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| Father's Highest Education Level |
Mother's Highest Education Level |
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