Fields marked with * are mandatory
General

Legal First Name *
*Please enter valid Legal First Name
Last Name *
*Please enter valid Last Name
Preferred Name
*Please enter valid Preferred Name
Middle Name
*Please enter valid Middle Name
Email Address *
*Please enter valid Email Address
Home Address1 *
*Please enter valid Home Address1
Home Address2
*Please enter valid Home Address2
City *
*Please enter valid City
State *
*Please enter valid State
Zip *
*Please enter valid Zip
Country
*Please enter valid Country
Citizenship
*Please enter valid Citizenship
Contact Number
*Please enter valid Contact Number
Cell Phone Number
*Please enter valid Cell Phone Number
Date of Birth
*Please enter valid Date of Birth
Overnight Visit
*Please enter valid Overnight Visit
Background

Mother's Name
*Please enter valid Mother's Name
Mother's Occupation
*Please enter valid Mother's Occupation
Father's Name
*Please enter valid Father's Name
Father's Occupation
*Please enter valid Father's Occupation
Will you be applying for need-based financial aid?
*Please enter valid Will you be applying for need-based financial aid?
Do you know any alumni or students at Susquehanna?
*Please enter valid Do you know any alumni or students at Susquehanna?
Academic

Graduation Year *
*Please enter valid Graduation Year
High School
School Name
Address1
Address2
Address3
City
State
Zip
Country
CEEB Code
the school is not listed above
*Please enter valid High School
GPA
*Please enter valid GPA
SAT Total
*Please enter valid SAT Total
ACT
*Please enter valid ACT
Academic Honors
*Please enter valid Academic Honors
Top 3 College Choices
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Academic Interests 1
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Academic Interests 2
*Please enter valid Academic Interests 2
Academic Interests 3
*Please enter valid Academic Interests 3
Student Type

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Athletic

Position



*Please enter valid Position
Recruiting Website
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High School Coach's Name
*Please enter valid High School Coach's Name
High School Coach's Phone
*Please enter valid High School Coach's Phone
High School Coach's Email
*Please enter valid High School Coach's Email
Club Team
*Please enter valid Club Team
Club Coach’s Name
*Please enter valid Club Coach’s Name
Club Coach’s Phone
*Please enter valid Club Coach’s Phone
Club Coach’s Email
*Please enter valid Club Coach’s Email
Athletic Honors
*Please enter valid Athletic Honors
Height
FeetInch
*Please enter valid Height
Weight
*Please enter valid Weight
Dominant Hand

*Please enter valid Dominant Hand