1.	Please fill out completely*
	Last Name   First Name   ID Number Name

2.	Test Scores
	Date   Composite   Reading   Math   Writing ACT           SAT

3.	Future Plans* Top 3 schools to which you will apply
	1   2   3 College

4.	Military
	Army   Air Force   Marine Corps   Navy   National Guard Branch of Service

5.	Work Chosen place of employment

6.	Other Plans for yourself

7.	Extracurricular Activities* List your top three activities (in or outside of school)and any offices held: List your honors and awards: List and describe you work experience with dates:
	Extracurricular   Honors and Awards   Work Experience

8.	Financial Needs Describe any extenuating family circumstances that may hindder your opportunity to attend college, including number of siblings, recent parent job loss, divorce, etc.
	Extenuating circumstance