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." Ii .. ~~yd 14&.-~ FAMll_. ineI"diDg ruiumer ~hooIs a:a<I pTI>glams you bave anondod begWliog wUh niDlh gro<Ie..rf .liMIt ~ .t1-..t¥btf5 J.--TIP'&l'~ Moth~·s full """"" Is .. Nro.e of School " ~- ocb<Jolo. Locatio" (City.Y ""l. Dates AIlCllokd A1!l~1c Y 10m &t4l'-06. nving?_'riat". 1J.- P "Home aIldreis if diJ!W:n1 from Y"""'" Hemo od<!ress if <!iff=t from YOM' .·List all o<ba =da.~.00 SAT] ~"-----s. Fatllet'. 1\0. Zip) ....Itllt~1jCY3 _ . full """'" Is h<>livin~1 ~L_._ ~. State.__ fA· ..

lIi.[.i I 1l__.~..'_.! ~ r .traDl!l!l~'i pa" __ItA"" .~~IhI. ~~ Uc'IIPJ!'~ h.I. iii ~ 6Ii _~~ \/!.!InEI~.i\Wiii~i:l.~~ "I Ii P'~ .B.IoiJ:I!I!iIiiMI :~.I. • _I.1 ~.l'i!IIliI-"~ flail . .. t I: ID '~!Ml_!2I(iiHj. l!f~"'TUI i!I .~ .~ i~' Il'~ 'I. J I [ BlJ0001S9 .~~ " 'iMoUliK! !!~ _tliJi'IIi"I~~ .IM -11~1 .-- 1!IIim'Lf. . ~ . '~_. .Jlilgu_~ •I g~ ft1..IbII~.I.iIOJilI ~ _ iI!I:~ 'I . l' I EldfJB~ _ Hii~'l!.l~'~ Ii! ~ ~ ii'f.J ~.

. do yo.<..I.t""Je. ~.es!ra Il Politi<.'1 I .. ViSllfl Art.oM".1l>I. "" .x you to .oUegel"'''''- "".. 0 Clublln~OIIlUlol/RocteatiMaJ· o 1nter..Ii .1ttJ~... IZI QUb/llmrnut.""tia OJ VocallMlc 0.. IIU000160 ..~ PJl!a:se 1m tfu= e.e Ilsa' many studenlS' plans clo~ queotiotls(circlo on. _I G<ooi>s Z5 salllll) U SIii~ Oo.tiOM- Ir yau l'Iawil!p're:wkJlHly ".t.1'(0) .IlrOlll)S a " ..W! fist ilny non~ ~CfdCIllIc' df'S.arsor YCiti "sid@lJ.IIemy~li •• 01 JoormIi$IlI' Debat.a~I.1){"'" 010 floI6 Hoctqo :12 'rocl:.pUN I•• Hon .ltI!-lhrl'dj. we reo:>gnU.VRomoIiooal 1Ji1hjJ.tdo!ifI. <!iootJo to tho followlllg oi).rJOllr~ awing the . 35 I/restOIlIj Nlacr!lS1< Se<oM FN'I~ If • 0I0l. iDdi"I. ~ aour.llolItted tO or teen tllplGfCd' lit IIomIrd...I Q)M. : 01 litis.!'\.. ~ AI tfl.mm<1II 09 tl II 06 W'ltI"9/I. 02 DrI.dMllos IIlI SIW'' ' . fl!-.tinc. .readr listed.ll ~ D.!nd 115 Ofdl.$ and ccuntrJes.rt.flnlf. ).amtlt's: or l.e! -" lll«or Z& ~ i! ~ III 31 3J 101 :IS leoots -~9....._Q1:L 31 Gill..e -. Ii! IntolaJIJ.. wttere 11 .. oon:51cftf ytlilr ac:a4mti.... CI1o«Ieadlo. whicO .s ac-e. W>li<1lr0'l" Reli<J:l.~t . 91 ve til... . U "'.~ fa tat.... ? flow aeffnJ'm art yoor utrKlllnlcrJlaf aad/or . ..ince fCII!JllOSt? 1"i 0. twa coUer. ...at«.: p~toH7 111:1" deflllitl: do YOI.."."<ivt".4 P"9"'~ or fejNttmtOL j 100\ Y<WI ! . d.ort.CI'o>Koll!ltry volloyball 1II:..a.SotiiI~. 18 W 11 Bnlie!billl "'Cie-w FeoMl footboil Coo(! !Io:I.0 B. l ... Mil G) ~bso:utettC:ertain pl..idI:..}. inteaijlil!d "vel of partJdpall .~. ...qial.espana " "rrik~..j ~ ..

>:ilu>tiOD fi>mls.on onendo:! pUiod of time" ple= chocl: yes h=. i~ ~h=.... II~I<I> !IopO _"-01)" tban ~ ICl:It'V'~1:( .. • lobo!> "" for tomp:rcl!:~"S' of fOiJl'" IiIJIPUUtlCI'i:.v.r. l>ol~l\\!tl j n I1G\Jt~i'i)Un~ij ~!fl4\id'~. please ""Plain O~ a ''lI'''''''' ""ee .."." ~t.u~ r. .}'on:~! ~ them ~ =~~vd"pes~ to Harvard AdrnisSi= Th!:i application to teachero ill diIf""'" _ti=i< "... ....OY. .~No U!o. .in<::u=d rcpeat<iI' ilio:ipfuwy actiOn o...<p<~1 p.. .00...01.:sJ!~I.... you should Appl\<"anon ""jj". ' ... <If S<J'. iel1.00 -0\.l<ibati01l..'" ..w!. Ii- ~.em3tio..._elude< .O'OloI Of.tertta.!3~=>' <II""" Impor"".01. hmr e<>mp]. pje ..heel. Obout your .si!\l. . :..ting YOI!" pqrtion of tho funn~ )"" .".-l'y"" have eeerbeen ~ suspmdod.. th~= _"" will bem. incl~ a """.a\ Sclwol Report from tho Coml:non C.."t<who know you well.uo of school_>\s..Df~ 5_ . you< test seores . Vol\lOl. of paP<'..M. placed on p...1!. ... .."d the &. '""' 'last Ibm! yemY"Illu. new ci=mstuo.te a If you ""'~ Ial=.\e.atim! wtth the S<:l>oolhpOn.. Sod. 0"'1...ticina! &=la1lR4te ~""" .a1 E~ 1:Mt:S...'" two Teacher E>.. U Yes. Or otito! il'ItaSOI.t J!~~se gl\le "i'CM"~iKlJe. "10 .bo1lld gi"" them ' 5UbJ!>. after you 10"" ouh~d !hE folm.....00 0&.IiI..' to ""yo! th ese quostio:ns i> r= aplOm "" • separn< .~ If_you etrended-a d!fk=t ><hooll2st l:e<t. oowttsy toy"'"' teeehera. or . . )'Out 0>\alSd0...00 HU000161 . .V.P-or"l N_oIh<I".obmllll:ily fur.. i<>ordA~_ Placemellllitst '~ 'o.". .lt avoilibk: . ~ from school.o ... oJ>d pr<:f .... "Otiogth. d ha . hiI""'" ad<l!til>. biy lu"" tiiqght roo dUIih~yom Ii:naItwo yn.tor Y""" statwJ at schQoLyou m1l5' notify us as soon as pas<I..dbl"Ub S. If tho """.frau h.O\.j~ Oy your l"ozIrur counselor. •• ' I!~- Or es ...l)'l.~ level.. aI..

00 110 3 4t) I In Ule'SPau provicl<:d below.'r " ' 'J : ft\1c. Jl«1 if "".ra . ~".1he .t. .lX) .it~roG5"~'f '!to.i' ~f'l~ IlIIYilOl)'> O'i.K IDQ'ER1ENCE ~r~~vV Co~l' Proo.J V 17 II V V 17 II / V VV V '/ !j /VV / / 1/ IIV V II ~-16 'HO ql) .lIa1ifiJ ...-.~ "1$.. .5 )) I IO~'si\1j'~. 1~l<\ .i~ _ J J f--. or 00' sepa_.ro."i"\~'l»i 1t. !: HU000163 .Do'fl'l~ \\odov i . )citnct._. . 1tom.G. 1u\o~il'O) Wijrk. (~~ du\ \9t'o.:.0'1. please describe . in 1'10\010.or employment) yon ~.. -- j .i\ien S~ci~kL.. locld dur. '0 (..~~ lCr. f-----.(1i...g. . of thee". k~1 ~'"ftl\\i!il\'fI:OO.~ ht .q~-06..i".t\\Oln ~dr.'I~[IIl'''~OllO''\.Co.4 \.1I:I. ~ J J pu=e s 51 ') ~'" !tici!"'" I )'CO IJq.------.. Co-kao '0').t\td~ '()~'\m" ~~ Wllt'fltlt&il. 51 30 30 p"" Cc~\ &. ~ 1 t I 1 : ~ "!....~bJ (t:W..<... . ..\!i three y.\d u~lty \\-~Y4mmir».bCn.\ WD.~iJ 1-N tHO n. Wo.~\2 "i'I.oo ()q.LliN foY ~ '01...0$5"'Y. b-!~ ~~ ~' . V~l\i\"~~\ ..~ m. M~h .ri0llc:e) b as hod tile tIIosl "'wUpg for you. -'.t !It..l~ \\o.o.w.coII'Il<1 and/or IrtC\...tt~. l11l'Ji{. .c:-? I. ~t-co\'ikJ). Pr~~i~Co..\ 'fI.\!6 ~c..OO-I>'.y .&1'II!I. '00 I boun I f--- I Uot ..u>o."l spent per ! j 'WCI:t i I t i i !.~fM1T'01 .0. \lc.\'.WOJI.0'\~-c.""q~-.\ flRt\t 'll!..rtll'lin" .w ~otSr ~hDlMn.iI\\ . J j --.\t(.... !lCtivilies (UQacum<>lbrr aed perscnal activities or work cxpe..tWlfl1i~ 6\.Yi.."y job (mciudlng ".\id..ail".'00iGip\al<lbJi ~lJP'oo. and why.. f--f-----.) Sool\'1 I /' q-10 q-IQ )Sy.."Wei. k.'00.""".~&i St.

_ ....__ ~ ""W _ ~gg/lliret Vh1fit" ~~ ~~ CE£SlAcr oodo: '?.. ..c..""""'''''''''''. ~ ".. ... .......~ ...~~~W~~·c..t>at-~~ . col"" rcligio..tcs.£J~'~ ~ .""' fomily Ed. .._.r~~______... :.t '" <tbni< orl.~.." ilnpuriMtobO!l1 Il>e appIlOi-Ol'... '" ~ ".·".. '"'PY. .fo~ ~_""""_'"""""..._._ y._·""odi.". &. We..''''"'''''''''''''''.."lioap...o[~."".t.... ."iII".ihy..Col1egcs do not plO'I'ide ~ to ~ ~ to app~ts 1M'" BlUdenlS.~"""'"'.' _ . "'.io..D:d UIUl'~es lH ~~~~~ ''''''lII..... We ere ~y il1_"..(Jl\t'.S' fl)....""".._yj !'Ito:»nI~ .·I.. ."'"_ ...:5L~·~~·k~... __ .luQe fuDDS ~dl as: !his cee.______:.~.. g>:ald\tl for y~ ~ssistance~ ...-~ ~.-'.Jl!y.~·Wdt......~...ca:nmiIkd"'~aI1 ~poIi.YJ~_~...._ LQUl .. os.... ""=_ .D/O=J.·~·$alQ!l·s..•.No d!sti'ndi'..=-:t. YOIl .... eeeccraged to l<ccplh<: original cflbj..... .....~_'_110("". Ie "" ... cx<tlqlt frmn ·the {ed=I~uIa!i"" """I=entioa TIIloD:: cftbo of 1?72..!:ntnts bjghly =d ask Ills:t" ro.. . A! ...-'. DReguW'A<IioA --'l"rnaI'~. ..~.:. [Glm...:w~~ ~._..... .. nmom.... wille JOW' oppllc:o&'l with ~ _ ~.~"~.~..u fOry<>to:"""pcn:~_ 'Il:.... ~-"'='_ - ..~. imoltl>Oli<>o below "-""I givathi$ l!val •• tioa.on wiU be DUUle bdvreeD it Dd: the coD.s::."""".. ....'doti=.......S!o(e Soc:iIH S=zrirJ }Io.~~ OW· · ·_·-.. or thcso_SI1Id<nt..~..~·A~J@D..-·_·.. WI you h<>_"..dditioual._·_..Cak _ h_... ·r""..~WtEcm-Clad: ~:_"""-._ _ .:""..~tJr......~o Sw~t~: ~1~UI~k~~~~~Jr-~~=y~~ . .Oi><iIa ~4l'qo:1....·....o.. ..: shou1ti ib(: . ~c""lJi".~"'~"fIZIII...''''''''''..."!"'. dell< n=d ..j ·filW~I.V_ .. :1: j . k. ....hidI may mc..-..who ...lo ....__ . '..~.'--"'(_'__'_01)"'~- ~~: School you ~Q~~~ ~ ~9t&~·~· ~~·_~ 2iP.~. ~.~... ~UJri.k..~~~_~_~ ~~~~~-~~~ __ ~N~~ '...a._.·_l ..~ _·P!=o>odlocl:~b= 12I~_.....Fill m applying!ha\ ""l)'-" T""eher !I. pm"" rue._..... ..._ ._ ~ HU000166 .(l914f_rlns _'do Mve eeeess t6"'tIld_r·p~ fili:~~.. ·_·~~· .......o!ad:o:Iissioa... . W~~..... ._·_ .rae1l!i ese Qr..~f""""'" r""".... r_·_.ge that'it may be: Yc::si»ed m tbt: ~...o- ._..... _·.""""'.-.....l.. _.._. ....~. .""...._""...·Lob_ ..this Corm...""'..... - 'l'P< . ...I>j=' '" oad> cclkge t<i ~ .....~. ·_·_ ..II& ~ ' _.....I!~yl''l: listed abo .....""" j><OOO$Il at pnv...~~d '-=.. "Wl'= ..YJ..!i9~~' " h> '''''''~ _. ... ._""""'""'_· ·..Coft+~~Part::J...... u.>ollq.0UA0': -e .. ~..-<p>n'<I on b<boIf cf dUs ~t is ~.r..._._..... Iere.__ ...~._..oryoll 11tinl<..__""'-.. ~(U..". : .. Y"" . de<li.LQIp'I. fann ~ the knoivlcd.*" .<:..... _ _ ........_a-·$d~ .r.TC1I ._'''''-'''''''_'~."..~..nd-I'ri ~ __ "YY\ ..~'"...."".We value your j A \eJ cOO'J.._.. t".yo-._.'1 · the iJ1stI'Uctlo ....·~ . The CO~ts 1iI.' ..te ~ ...- . ·_C'O'OO<·_-_.._._.= ..ACHEkEVALUATION ."""'"... . __ .~ <>fIN ~'fI_ ... _.a.... mroi<d. A ph""""'PY of Jl:ois....o..1 The Common __ " '8 _ TO THE TEACHEl10 i\-ppllca:tiOD 8fOllP ~(colleges ~ QQdid evalU2tic_JlS helpful Ul dlllQsicg from am~g highly qua1iiiod -CIIIdkIa...f IUICCla....IMIo.~"~.oW"o..._..ioo.~'. _....·""""· ··.~:.~4~"'Ba:b'.......-........·__~.." YO"' for use shoold th< . awl w~ '_Jq"."._..~~.~.t.~. "" .pjba... pod ""£bt)'QII "" en. .SL~~·~$L~'I • 'W~... ""cl='!"bq has roaD awl...~ CO!<FIDEN'I1.. 0<001...dmi$s... y_ import=< to .·..._""""'....DO "" off. 'Ibe odm"'.~.~1b- 'It. ro 1JlEHPIJ6wi..Co!pIo.D complete'thiJ:..:>o~-"-... Ory~T~~ ...oiYa:Jii. age. ....f_ )'QII mayh>v<> p.I!""""".._.sex.' . acadaWc on<!p""""'>l ~ f""~'~submlt)'llUrlOfi:oa>= p«>mplly..'_..~. ~.o::>Olld_ es~~<ntbo bo<U ....··~·~~ __ ...

jlll .~~!:.'t1dQV! _o.......JID. "5 WlurlrlaS this . 10 11iH ... ""·_·_a-.._. "osb!YOO"'''''d<oDie envelop<.pply.fa"l.£C' tl!e lise of tbb form._ ..·_·.._ . ...'1'-.....a.-... 1\ .""".'~·_·""'f'ii~gflofnlll"lll.~ll1his~ISDdiowllll.."""'''' ..~ .0«-.. ...lffbGtry '" CEE~Acr~\fi __ '.a.~·«ao.. "".-..Y.. " _....._. ['-'""'WI fV- 01H 8' BACKGROUND D\'FORMAnON Howlo"ghav....'_-.s-..r. I ! I ~"_-·~· ..ofl '01". ..__ ' . ._.....~·omo~.8 1>0"...n·Son....'~fI'1rl)~ . ~·_·..o": £"'._..APPLICANt: _-.-..... ~m~--~~~-__ Cky«TOI&P' ~ ~ ~-'M'-"O..-wl:o~. A type)._"..n<o""""·""""""""~.in.""'-"'.-u-w:l-C1Ok- _"""'...bi.CoIby·~·C_·OoJ...ities l'be_""""...._ __ . \oj= '" cad>..<1<._·_..~~AWr1I~ ~~k-..!I~·~_·~ __ .~"~~k~._..t...~.fiml~N~l .....-e cD\..""'. nd taeyo... ~ou~.-~. rd)'<lG 1 .1'1 (o~.. W~ .."-<"'f words <lat com...-"..ype b<Iow ~ give this (OWl =I..-...Mddti.... f .I·L..'\:'). .__ L .i5'.-a-J.~1>= • TEACBERJ:VALUATION __ ~" .~~.__.. .e.Cr.._t ""if.....""V'reY' SdIoo1A~: i__. 'Mia ....&.. -. ~ }o···#Nc· 6..I .'L.. fill in "'" ~..."I'p-g. _."'<o __ •__ _...~ _ ~ !'osi'.-.'.L5-'-e"--'I..Ieo<h.. '" y=r mJild t.~... IIW."""""..~ ..4P~ .... (ICI!o..·I\ol:IbI.d:D..·_·. No d~dio!l: will be made be~ It ud th£ caU~e"s OW'll fona.!Mr Yea( ill «bool -------------'-- I ~ )"u'fl..o _ va...·-...o.... Fe fv.._.. _.·_·_·_·..... listed above· enceur. or -..a....~.. __ Sccial SocurityNo.Wl. ·~·~ ".. y~~·thotiII .. (pJ._~·.fb~t you a:..._d _ ~~..w...-.._· " ·_·. .ce'~k I -5 HU000167 ..yo.. __ -'~"'-e<l""c"-'t..-~. T~E~ which l""' .~ .......eek ~~J it.. ....eQk~·a....."" .<>on...ry "..._ ~·s-a... .rc"""h''j Ibo level ):k~lt/. ~ tI>..-·__·...." ~y <flbis~ Of w""'''''~ ~ Day. clcct...____ ~77· I_~ __ - Scboolyoo""""fteod. ...! .-..{.. 12lh) _ ' of"".~ __ ~~ prllll In blaold:r>k..$ if¥J ...l'-'-~_~:---eb~+- ~: __~~~---~iiI1I41i1:mz1 __--~'~~~~W~~7F=--.-< prim Seoc:md>rySchool: HwvlA . ~-""'.......= /7'::: pJaose -.._·.......~ lil'Eod:r_':' ... 11. Nam. _ ~~.. il1!l.""~·WW.-Ildlu.~.ftlle ooliogc<L flea._· ..._.l..l'.... -""""".""" . Lc..-·IlaiI·-·-·.~ ...WOO$Cl9".""""""". :~w~·_·_· -~. fkilli.-.._."c!op"'l~.._ ._.k....' ~ ~ ~_.._·..nive'JI.....'v(·y... _ ~w.j _ by. ~...-w_-.'u........v.....I.Sc..... .t~..' ..TCll.. /l. • - ... toIle$e to 5V ffLt3/rle/ilT/r/.c.-'..ItlYJ _......·Wdcpll·WI$lCl:l~..~ The eollegt::t11ln.~(I...._._ .'\~( ---:-(_It_~-:----_.e:..&.l...... !._·_·.<-e..~... a..d u._.:.hone:{ "' ("17) Nt:!1~ t/aV'Y'lV't4 1t>z....r€. ..-.-·"""""..e MA r'vd1'~i. 10 co""..... ~~.s.. Iougb.""'" ... ...~-.av1± d .~)br •• ~~ ~..Y .....M"~~M" •• C"O"'·. ..Pl flflttolAt-_.. -.._.. diJlkulty w....I........... . -- _...I I .... ~J=rz~~J.C PftfAlft/rl/)ATf oj...__._taI? W~ are JVl~v"\. ~~_ £JI'I'E~((jIzvM.·~'ti\l::ra... ....~... ""deal'. copy.O=O"'"""'._._OojJqp.a iv1 SdvJ ~~_ ~t ".-...I..*..J.z.iltg tbo._ ~ ...f Yv-:h..._._.._...c:r...e List tho 00""'" .~~6t~·~OW .t...... oJ ' o!6o«SI'~ Tood='..Sl._._ __ ·-._""""' -w_""-. .-> ' ' ._ .---'--- s"'d"""""'..._. "'9. sUlden~ ootil:g {"" oo<b lb. __ =.-·.....

j.~:::. f Please..-_co<".. UM.II I I '.Ucontact in lUI emergency. address and pboce number of a local contact) to you: Name/relationship H orne Address: Home Phone -'---'- _ Work Phone (... Ci<."elope.. or Plio.#'j_. _ K. __:tc.-- __ -e- J"'-.~ I FRESHMAN' '~"-'" DEAN'S OF~CE RECORD FOR¥ (PART 3) enclosed seIf-~ddreucd (pI... "".".-. i"""lE·.:.__' -'-_..:_·-. I.l) by May 1 2002 to the Fmbwau:Deali's Office Iu lhe. .~n'jt...__... Date of Birth Pre-existing medical c~ndiri<>nand/or allergies 'ParMl Or Guardian's Nome: Home.· . Ifno! mother or fOUl"'".. HoroePhone ~'"""-_ WQ~ Phon'_~.Address: -"t=-aw:.: Interruuianal Students (please provide the name..~~D· .-"·I~ . Social Security /I. I .c~=-·=--:.P'":t8·1..retern this form (atlilched-to.---. Initial !"ItA .and .. ~ 02103 [fiiiJ..... "This is !he person we wi..:r . ". ._ HU000168 . indicate relationship 10 you.n~) Fii::l!Name .