NAME ______________________________________________________________________

SS NUMBER ________________________________ STUDENT ID ____________________

ADDRESS __________________________________________________________________

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HOME PHONE ________________________ WORK PHONE _________________________

YEAR: __freshman __ sophomore __ junior __ senior

HIGH SCHOOL ATTENDED

____________________________________________________________________________

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ENGLISH MAJOR DECLARED __ yes __ no

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Application Checklist:

____ Letter of application

____ Transcript

____ Writing sample

____ Letter of support from faculty member [optional]