Title: Mr. Ms

First name:     

Last name:     

Address: 

City:         

State:        IN AL AK AZ AR CA CO CT DE DC FL GA HI ID IL 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

Zip code:

Email:     

Phone:   ( ) - -

Date of Birth:

High School:

Sport: Mens Basketball Women's Basketball

Head Coach's Name: (optional)

Year Graduating from High School:

Have you applied to IU South Bend:
Yes No

My Cumulative GPA:   2.00 - 2.50 2.50 - 3.00 3.00 - 3.50 3.50 - 4.00 over 4.00

My Class Rank is in the upper: 10% 25% 50%

My tests Scores (if available):
SATV:
SATM:
ACT:

Events:

Performances:

Anticipated Field of Study: (optional)

Career Athletic Highlights: (optional)

My other activities at school or my community: (optional)