Last Name First Name MI Grade

Student Information Sheet

Birthdate:_____/_____/_____ Your Email:__________________

Home Phone:___________________ Parent’s Cell Phone:___________________

Address:__________________________________________________________________________________

Father/Guardian:____________________ Work #:__________________ Email:__________________

Mother/Guardian:___________________ Work #:__________________ Email:__________________

Please list the following (Whether they are school related or not):

1.) Sports/extracurricular activities you are involved in (or plan to try out for):

__________________________________________________________________________________________

2.) Clubs you are involved in:

__________________________________________________________________________________________

3.) Hobbies:

__________________________________________________________________________________________

4.) Where are you employed?

__________________________________________________________________________________________

5.) What type of career would you like to have once you graduate from college?

__________________________________________________________________________________________

1.) What is your best subject?

__________________________________________________________________________________________

2.) What are your bothers and sisters’ names and ages?

__________________________________________________________________________________________

DATE CALLED

REASON/ACTION TAKEN