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Content: Permanent residence Number, Street, and Apartment Number City State ZIP Your address at school (if different) Number, Street, and Apartment Number City (if studying abroad, add country) How is permanent residence established (At least two must apply.) Home address for school registration Place of registration to vote Family’s primary residence Other: State ZIP Home telephone ( ) School telephone ( ) (if different) E-mail address Age Date of birth Month/Day/Year (Check one) I am a U.S. citizen U.S. national Resident alien expecting citizenship by the date of award Will you be studying in Europe, Africa, the Middle East, or India during the Spring semester Yes No (If yes) Where Name of nominating institution Current cumulative GPA on a scale of Your undergraduate major(s) Number of college credits earned to date Expected date to receive baccalaureate degree Total number of credits required for graduation Degree you will receive Graduate degree(s) sought Concentration(s) 11..
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