Personal Information

Today's Date

First Name

Middle Initial

Last Name

Father's Name

Father's Occupation

Mother's Name

Mother's Occupation

Home Address (street)

City

State

Zip Code

Country

Date of Birth

Email

Home Phone

Cell Phone

Height:

Weight:

Year of High School Graduation

High School

High School Address

City

State

Zip Code

Phone Number

Academic Information

GPA

ACT Score

SAT Score

SAT Math

SAT Verbal

PSAT/PACT Score

Class Rank / Out of

College Academic Interests

Your Level Of Interest In the University of Northern Iowa: (Top Choice, High, Moderate, or Unsure)

1.

2.

3.

Athletic Information

Event One:

Mark One:

Event Two:

Mark Two:

Event Three:

Mark Three:

Event Four:

Mark Four:

Athletic Honors/Awards

Other Sports