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Attention Prospective Students: Please complete the following form with as much detail as possible. Double-check your contact information - this is the only way we can get in touch with you! Review your form when you are done by clicking the Preview button at the bottom of the page. You can then send to us or go back and edit if you find errors.

Fields denoted with (*) are mandatory.

Personal Information
   
Name(*):
Address:
City:
State: Zip:
Natural Weight:
H.S. Weight Class:
Anticipated College Weight:
Home Phone:
Cell Phone:
Birthdate:
Graduation Date:
Email Address(*):
Mother's Name:
Mother's College:
Mother's Occupation:
Work Phone:
Father's Name:
Father's College:
Father's Occupation:
Work Phone:
H.S. Coach's Name:
H.S. Coach's Home Phone:
Brother/Sister(s) Names & Colleges:
If Parent's Address is Different, list it here:
Hobbies and Interests:
Age you began wrestling:
Strength as a wrestler:
Weakness as a wrestler:
Goals for the season:
Goals for college wrestling:
PSU people you know:
Most influential people in your life:

Academic Information
High School:
High School Address:
High School City:  State:  Zip:
High School Phone:
Guidance Counselor's Name:  Phone: 
Academic Honors:
Academic goals for college:
Career Goals:
Academic or Other (Pell, PHEAA, etc.) Grants that you expect you might qualify for:
Are you interested in Penn State: yes, very much yes might be
Other colleges you are interested in:
Potential College Major:

ACT: Date ACT Taken:
SAT Verbal: SAT Math: Date SAT Taken:
High School GPA: Class Rank: College Prep: Yes No

Statistics
Height 
 Weight ClassRecordPins ForPins Against
Fr. Year
So. Year
Jr. Year
Sr. Year
High School Overall Record (wins/losses) 
Post Season Wrestling (advancement in regionals, states and freestyle accomplishments)

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