Personal Information

First Name Last Name    Nickname

Street Street 2

City State Zip Code

Email Home Phone

Cell Phone Date of Birth Ethnicity -- Am. Indian Asian Black Hawaiian Hispanic White Other

Family Information

Primary Guardian First Name Last Name

Relationship to You -- Mother Father Grandmother Grandfather Step-Mother Step-Father Aunt Uncle Sister Brother Other Marital Status -- Married Single Separated Widowed Unknown Phone

Occupation Last School Attended

Secondary Guardian First Name Last Name

Relationship to You -- Mother Father Grandmother Grandmother Grandfather Step-Mother Step-Father Aunt Uncle Sister Brother Other Marital Status -- Married Single Separated Widowed Unknown Phone

Occupation Last School Attended

Number of Children in Family Will Your Parents Apply for Financial Aid -- Yes No

Academic Information

High School Graduation Year

GPA SAT Math SAT Verbal SAT Writing ACT

Have You Applied to Goucher  -- Yes No Interested in Applying -- Early Decision 1 Early Action Early Decision 2 Regular

Top Schools of Interest

Intended Major     Interest in Goucher  Low Medium High Top Choice

Athletic Information

Position Point Guard Shooting Guard Small Forward Power Foward Center Number of Years Varsity -- 1 2 3 4 Are You a Captain -- Yes No

Height Weight Uniform No. PPG RBG

Assists Steals Free Throw % Team W/L Record

Athletic Honors

High School Coach Email

AAU Team Coach Email

Other Varsity Sports Played: Field Hockey Lacrosse Soccer Softball                                                  Track & Field  X-Country

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