Your last name

Your first name

Your middle initial

Your permanent mailing address

Your city

Your state

Your ZIP Code

Your Social Security Number

Your date of birth

Your permanent telephone number

Your driver's license number

Your driver's license state

Are you a U.S. Citizen?

Your Alien Registration Number

Your e-mail address

What is your marital status as of today?

Month and year you were married, separated, divorced, or widowed

What is your state of legal residence?

Did you become a legal resident of this state before January 1, 2003?

Month and year you became a legal resident

Are you male or female?

Do you want Selective Service to register you?

What degree or certificate will you be working on during the 2008-2009 school year?

What will your grade level be when you begin the 2008-2009 school year?

At the start of the 2008-2009 school year, what do you expect your enrollment status to be?

Are you interested in work-study or student loans?

Will you have a high school diploma or equivalent before you enroll?

Will you have your first bachelor's degree before July 1, 2008?

Highest school your parents completed

Do you have any drug-related convictions?

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