Date:   Date of Birth: //
 
Cell Phone:   Carrier:
Gender: 
 
Name:		    First:
 		    Middle:
 		    Last:
 		    Preferred:
 
Street Address 1:      Street Address 2:   
City:      State:      ZIP:  
Home Phone:      Email:   
High School:      HS City:      HS Grad Year:  
GPA:     ACT:     SAT:           College Entry Term:     
Missionary Kid:      Minister's Kid:      Parent Attended OBU:     
Home Church:        Church City:       
 
Intended Major:		 Major 1:
 Major 2:
 Other Major:
 
Interested In:		 Music Interest:
     		 Sports Interest:
 
  Preferred First Name Last Name Email Address
Parent Contact Information #1
Parent Contact Information #2
 
I am Very Interested in Attending OBU