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Personal Information
First Name: *
Last Name: *
Middle Name:
Preferred Name:
Email: *
Facebook Email:
Address: *
State:
AL
AK
AR
AS
AZ
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
AB
AE
BC
DC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
UN
YT
PR
VI
City: *
Country:
Zip:
Phone:
Mobile/Alt. Phone:
Gender:
M
F
Date of Birth:
Place of Birth:
Hobbies:
Fax Number:
Most Influential Person in Your Life:
Friends/Relatives Who Attend(ed) Nebraska:
Siblings Names and Ages:
International Student Mailing Address:
Additional Contact Information (Parent/Guardian)
First Name: *
Last Name: *
Relationship: *
Father
Mother
Alternate
Step Mother
Neighbor
Uncle
Sister
Grandfather
Guardian
Aunt
Friend
Step Father
Brother
Grandmother
Coach
Other
Spouse
Parent
Girlfriend
Boyfriend
Child
Guidance Counselor
Wife
Cousin
Husband
Club Director
Step Sister
Step Brother
Athletic Director
Email:
Home Phone: *
Mobile Phone:
Work Phone:
Extension:
College Attended:
Occupation:
Employer:
None
First Name:
Last Name:
Relationship:
Father
Mother
Alternate
Step Mother
Neighbor
Uncle
Sister
Grandfather
Guardian
Aunt
Friend
Step Father
Brother
Grandmother
Coach
Other
Spouse
Parent
Girlfriend
Boyfriend
Child
Guidance Counselor
Wife
Cousin
Husband
Club Director
Step Sister
Step Brother
Athletic Director
Email:
Phone:
Mobile Phone:
Work Phone:
Extension:
College Attended:
Occupation:
Employer:
Athletic Information
Height:
ft.
in.
Weight:
State and National Meet Performances:
List History of Injuries:
# Years Competing in Cross Country:
# Years Competing in Track:
Other Sports?:
List Athletic Honors and Awards:
Event 1:
Event 1 Best Mark:
:
:
Event 2:
Event 2 Best Mark:
:
:
Event 3:
Event 3 Best Mark:
:
:
Event 4:
Event 4 Best Mark:
:
:
Event 5:
Event 5 Best Mark:
:
:
School Information
School Name:
Clear
Address1:
Address2:
City:
State:
AL
AK
AR
AS
AZ
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
AB
AE
BC
DC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
UN
YT
PR
VI
Zip:
Country:
Phone:
Fax:
Mascot:
Colors:
Website:
Principal's First Name:
Principal's Last Name:
Principal's Email:
Principal's Phone:
Registrar's First Name:
Registrar's Last Name:
Registrar's Email:
Registrar's Phone:
School Coach Information
Your Coach:
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First Name:
Last Name:
Email:
Title:
Work Phone:
Mobile Phone:
Home Phone:
Academic Information
SAT:
SAT Math:
SAT Verbal:
ACT:
GPA:
Class:
High School
2-Year College
4-Year College
Post-High School, Non-College
Class Rank:
Grad Year: *
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
Intended Major:
Registered with Clearinghouse:
Yes
No
1st College Preference:
2nd College Preference:
3rd College Preference:
Languages Spoken:
ToEFL Score: