Name:
First   Last   SS#
Address: Street City State Zip Phone Email:
Father's Name: Occupation:
Mother's Name: Occupation:
Brothers & Sisters (ages)
High School: Address: Phone:
High School Coach: Phone:
Principal: Counselor: Phone:
Handicap:   Average Score:
Recognition Achieved in Golf:
At this time do you have a definite area of study that you are going to pursue in college?  Yes  No
If yes, please indicate
Have you taken the ACT test? Yes  No  If yes, please list your scores.
English   Math   Science Reasoning   Reading Composite
If no, when are you planning to take it?
What is your approximate GPA?   Class Rank? / Graduation Date:
Have you filed financial aid forms (FFS, FAF)?  Yes  No
Would you like more information concerning South Dakota Tech academics and golf? Yes  No
Do you know anyone who is attending or has attended SDSM&T? Yes  No
Additional information: