Name:
________________________________________________________________________________
Last First
Middle Initial
E-mail Address:
_____________________________________________ (Please write legible - We will use this e-mail address for
communication about your application)
Date of Birth:
___/___/___ Sex: M
F
Address:
______________________________________________________________________________
Number
and Street
_____________________________________________________________________________________
City/Town
State Zip/Postal
Code County
Home Telephone: (____)
____________
Name of Parent(s) or
Guardian(s): _________________________________________________________
_____Engineering
____Landscape
Architecture ____Molecular
Life Sciences ____
Sustainable
Environments
Educational Data
Please submit an
official copy of your most recent high school transcript, including your fall
2007 grades as well as a copy of your SAT, PSAT, or ACT scores.
High School:
___________________________________________________________________________
High school name and
street address
Address:
______________________________________________________________________________
City/Town
State Zip/Postal
Code
College/Guidance
Counselor Name: ________________________________________________________
School Telephone: (____)
_____ -
Cumulative Grade Point
Average: ________ Class
Rank: ________ out of _________
Test Information
Please submit a
photocopy of your official test results from the following: PSAT,
SAT I, and/or ACT.
PSAT: __________ __________ __________
Date
taken/ Verbal Score Math Score
to
be taken
SAT I: __________ __________ __________
Date
taken/ Verbal Score Math Score
to
be taken
Deadline: The deadline for
receipt of all application materials is 5:00 P.M. Friday, April 25th,
2008.*
*There will be no exceptions to this deadline.
Jermaine F. Williams,
Coordinator for First Year Student Programs
Office of the Vice
Provost for Undergraduate Studies
500 Conwell Hall
215-204-7596 (phone) – 215-204-3175 (fax)