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| Graduation Year * | |
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| First Name * | | Middle Name | |
| Last Name * | | Preferred Name | |
| Address * | | City * | |
| State * | | Zip * | |
| Email * | | Country | |
| Home Phone * | | Cell Phone | |
| Birth Date * |
| Registered with Clearinghouse * | |
| Facebook | | Myspace | |
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| Father's Name | | Father's Occupation | |
| Father's Employer | | Father's Home phone # | |
| Father's Work phone # | | Father's Cell phone # | |
| Father's Email | | Father's College | |
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| Mother's Name | | Mother's Occupation | |
| Mother's Employer | | Mother's Home phone # | |
| Mother's Work phone # | | Mother's Cell phone # | |
| Mother's Email | | Mother's College | |
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| I live with | |
| The names and ages of my siblings are: | |
| The best way to reach me is (choose one) | |
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| Height | ft
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| Jersey Number | | Other Sports | |
| My academic interests are: | |
| My online video link is: | |
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| Country | |
| School State * | |
| Choose your School | |
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| Class Rank | |
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| GPA | | ACT | |
| SAT Math | | SAT Written | |
| SAT Verbal | |
| SAT II subject | | SAT II score | |
| SAT II subject | | SAT II score | |
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| Club Team Name | | Address | |
| City | | State | |
| Zip | | Coach Name | |
| Office Phone | | Cell Phone | |
| Email | |
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| My top priorities in choosing a college are: |
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| The =$school_name_caps?> students and alums I know are: | |
| My favorites hobbies are: | |
| The person that will help me choose a college is: | | Cell phone: | |
| The 5 schools I plan to visit are: |
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| I authorize the release of my transcript and test scores to YALE. |
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