The College Application: Worksheet

Write your Apply Texas user ID and password here User ID: _____________________
Password: _____________________
Personal Information
Full Legal Name (First, Middle, Last) _____________________________________________
Permanent Mailing Address _____________________________________________
City, State, Zip _____________________________________________
Primary Phone Number _____________________________________________
Cell Phone Number _____________________________________________
Email Address _____________________________________________
Social Security Number (optional) _____________________________________________
Date of Birth _____________________________________________
Place of Birth (City, State, Country) _____________________________________________
Emergency Contact Name & Phone _____________________________________________
How many people, including yourself, live in your household? (Include siblings in college) _________
What is highest level of education completed by your:
Father/Legal Guardian: (circle one) No high school Some high school High school diploma/GED
Some college Associates Degree Bachelors Degree Graduate/Professional Degree

Mother/Legal Guardian: (circle one) No high school Some high school High school diploma/GED
Some college Associates Degree Bachelors Degree Graduate/Professional Degree

Are you a U.S. citizen?

Yes

No

Do you have one of the following military affiliations?

Current or former member of the Armed Forces, National Guard, or Reserves
Dependent of a veteran
Dependent of a deceased veteran
Dependent of a veteran with a combat-related injury
Semester and Year You Expect to Enter:

Semester:

Fall or Spring

Year: 20____

The College Application: Worksheet

List all colleges you have attended or are attending from which you expect to receive credit from.

College Name ______________________________

______________________________

City, State ______________________________

______________________________

Dates Attended ______________________________

______________________________

Academic Information
Name of High School that you will graduate from ______________________________________
High School Code:
Dobie
Memorial
Pasadena
Rayburn
South Houston
443374
445773
445375
445373
446652
List the courses you are taking during your senior year. Please indicate any that are AP or Dual Credit.

Senior Courses

AP / Dual Credit

Semester (Fall / Spring)

Testing Information
SAT Test Date (Month / Year) ______/______

______/______

Math Score

_____________

_____________

Verbal Score

_____________

_____________

Writing Score

_____________

_____________

ACT Test Date (Month / Year) ______/______

______/______

Math Score

_____________

_____________

Verbal Score

_____________

_____________

Science Score

_____________

_____________

Optional Writing Score

_____________

_____________

The College Application: Worksheet

Activities
Extracurricular Activities
Activity

Grade
Level(s)

Approx Time Spent

Hours/
Weeks/
Week
Year

Positions Held

Description of Activities

Community Service / Volunteer Work

Service / Volunteer Work

Description of Service

Dates

Total Hours

The College Application: Worksheet

Employment / Internships / Summer Activities

Name of Employer / Activity

Description / Job Title

Dates

Talents / Awards / Honors

Talent / Award / Honor

Grade
Level(s)
Received

Description

Hours per
Week