Please fill out the following questionnaire
Click the SAVE button below when you're done.
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Please be sure to fill out all required fields:
First Name, Last Name, Select School, H.S. Grad Year (e.g. 2015)





Personal Information
Your Name:
First Middle Last
Street Address:
State / Zip:
Friends at Harvard/Relatives in Boston Area:
Date of Birth:
Month Day Year
Birth City/State:
Email Address:
Home Phone:
Cell Phone:
Most Influential People In Your Decision:
Hobbies And Interests:

Parent's Information
Mother's First Name:
Mother's Last Name:
Mother's Job:
Mother's Work #:
Mother's Cell #:
Mother's Email:
Mother's College:
Parents are:
I Live With:
Father's First Name:
Father's Last Name:
Father's Job:
Father's Work #:
Father's Cell #:
Father's Email:
Father's College:
Brothers'/Sisters' (and their schools if in college):

Academic Information
Please use the SELECT SCHOOL Button to choose your school.
School Type:
School Name:
School Address:
School City:
School State / Zip:
School Phone #:
School Fax #:
Counselor's First Name:
Counselor's Last Name:
Counselor's Phone:
Intended College Major:
Graduation Year: GPA/4.0:
SAT Test Date:
Jr. SAT-CR: Jr. SAT-M:
Jr. SAT-W:
Sr. SAT-CR: Sr. SAT-M:
Sr. SAT-W:
SAT II Subject 1:
Score 1:
SAT II Subject 2:
Score 2:
SAT II Subject 3:
Score 3:
ACT Test Date: Score:
Class Position: Class Size:

Athletic Information
Coach's First Name:
Coach's Last Name:
Coach's College Attended:
Coach's Office #:
Coach's Home #:
Coach's Cell #:
Coach's Email:
Colleges In Which You Are Seriously Interested.
Other Sports:
Offensive Position:
Defensive Position:
Preferred Position:
40 yd.:
100 m.:
Jersey Number:
Athletic Honors:

When you have completed this questionnaire please click the save button.