*Birth Date
(Will be kept confidential)
Format: MM/DD/YYYY
/
/
|
*Gender:
|
|
|
|
| |
Prefix:
|
|
*Formal First Name:
|
Middle Initial:
|
*Last Name:
|
Suffix:
|
|
|
*Country:
|
|
*Street Address:
|
APT/STE/UNIT:
|
|
|
|
| *City:
|
*State:
|
*Zip Code:
|
|
|
|
|
Telephone Number:
/
-
|
*Email Address:
|
Don't have an Email?
Get:
Hotmail, Yahoo, or GMail |
*H.S. Name:
(If your school is not in the list, leave blank)
|
|
| *Term of High School Graduation:
|
|
| Please check all that apply: |
|
|
|
African-American or Black |
Mexican, Mexican American, or Chicano |
|
|
American Indian or Alaskan Native |
Puerto Rican |
|
|
Hawaiian or Pacific Islander |
Cuban |
|
|
Cambodian |
Other Hispanic or Latino |
|
|
Hmong |
White or Caucasian |
|
|
Laotian |
Other |
|
|
Vietnamese |
I choose not to respond |
|
|
Other Asian |
|
|
*Are you a US Citizen?
Yes
No |
|
|
*Planning to Enter UWM:
|
*Will Be:
|
|
Major 1:
|
Major 2:
|
|
Major 3:
|
|
|
|
|
|
