Name		Phone
Address
City		State Zip

E-mail address

SAT:
Verbal	Math
ACT:
English	Math
Reading	Science
	Cumulative

High School Name
Address
City		State Zip
H. S. Advisor:
Physics Teacher:

Check all that apply:
Please have a V.U. Physics/Astronomy faculty member call me.
I'd like to talk with a V.U. physics and astronomy student.
I have visited the V.U. campus on month January February March April May June July August September October November December / day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / year 1999 2000 2001 2002 2003 2004 2005 2006 2007 .
I plan to visit the V.U. campus on month January February March April May June July August September October November December / day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / year 2001 2002 2003 2004 2005 2006 2007 .
I plan to enter college in fall of year 2002 2003 2004 2005 2006 2007 .

I have the following questions: