Personal Information: Personal information including your name, address, telephone number(s) and e-mail address
SSN or Government ID Number
 Enter your social security number or government ID number.  Enter only numbers.  Do not use spaces, hyphens or other punctuation. 

Last Name
 Enter your last name 

First Name
 Enter your first name 

 Enter your middle name or middle initial 

 Enter your previous last name if you have had a legal name change 

Date of Birth
  (mm/dd/yyyy) Enter your date of birth in the format MM/DD/YYYY or click the blue calendar icon to select a date 

 Select your country of citizenship from the drop-down menu if you are not a U.S. Citizen 

Address Line 1
 Enter your mailing street address 

Address Line 2
 Enter a second line of your mailing address (if necessary) 

Address Line 3
 Enter a third line of your mailing address (if necessary) 

 Enter the city of your mailing address 

 Select the State of your mailing address from the drop-down menu 

Zip Code
 Enter the Zip Code of your mailing address 

Phone Type
 Select the type of your primary telephone number from the drop-down menu 

Area Code
 Enter the area code of your primary telephone number 

Telephone Number
 Enter your primary telephone number (enter only numbers, do not use spaces or other characters) 

Additional Telephone Type
 Select the Phone Type of an additional telephone number where you might be contacted from the drop-down menu 

Additional Telephone Area Code
 Enter the area code for the additional telephone 

Additional Telephone Number
 Enter the number for an additional telephone (enter only numbers, do not use spaces or other characters) 

Email Address
 Enter your primary e-mail address 

Begin Studies In...
 Select the semester in which you intend to begin your studies from the drop-down menu 

Athletic Interest
 If you are interested in participating in NCAA intercollegiate athletes, please select the sport you are primarily interested in from the drop-down menu. 

    required and     optional