Please take a moment to answer a few questions about yourself. Required Fields in Bold.

Oregon State Graduates that you or your family are acquainted with:

Please list honors/awards that you have received:

Personal Information

Name

Birthdate

Address

Home Phone

Cell Phone

E-mail Address

Mother's Name

Mother's Occupation

Father's Name

Father's Occupation

Education Information

High School

Graduation Date

High School Core GPA

SAT/ACT Score

Academic Interests

Junior College

JC Graduation Date

Athletics and Other Extracurricular Activity Information

High School/JC Coach's Name(s)

Coach's Email

Please list your best marks in the following distances (100m, 200m, 400m, 800m, 1500/1600m, 3000,3200m, 5k, others):

List Other Sports/Activities You Participate In:

Please Verify the Charactes Before Submitting Your form: