First Name:

Last Name:

Address:

City:

State:

Zip:

Phone Number:

E-Mail:

Your Interest in OSU:
Extremely
Moderate
None

Top Three Universities of Choice in order of Preference (including OSU)

1.

2.

3.

High School:

High School Phone:

ACT:

SAT:

PSAT:

Graduation Date(MM/DD/YYYY):

GPA:

Academic Interests:

Yrs. of Experience:

Position(s):

Club Team Name:

Club Coach's Name:

Height:

Weight: