For Spring 2013 or Fall 2013 Enrollment
APPLI C ANT 申请人
Legal Name 姓名
Last/Family/Sur 姓 (Enter name exactly as it appears on official documents.与证件一致) First/Given名Middle (complete) 中间名（完整）
Jr., etc.
Preferred name, if not first name (only one) 若与名不同，常用名 Former last name(s) 曾用姓 US Social Security Number, if any 若有， 美国社保号
mm/dd/yyyy月日年Required for US Citizens and Permanent Residents applying for financial aid via FAFSA美国公民以及通过FAFSA申请经济援助的有就居民需要提供此信息
Birth Date 生日 ________________ 0Female女0Mal男Preferred Telephone电话号0 Home家0 Cell手机Home家( ) Cell手机 ( ) Area/Country/City Code国家地区城市区号 Area/Country/City Code国家地区城市区号E-mail Address 电子邮箱地址
IM Address 短信地址
Permanent home address 永久家庭
Number & Street号码 街道 Apartment #公寓
City/Town 城市 县 County or Parish 国家 或者教区4
State/Province州 省 Country 国家 ZIP/Postal Code邮政编码
If different from above, please give your current mailing address for all admission correspondence.若不同请提供录取联系的邮寄地址 (from自 to 到)
(mm/dd/yyyy)月日年 (mm/dd/yyyy)月日年
Current mailing address 现在邮寄地址
Number & Street号码 街道 Apartment #公寓
City/Town 城市 县County or Parish 国家或教State/Province 州 省
Country 国家
ZIP/Postal Code邮编
If your current mailing address is a boarding school, include name of school here: 如果你现在邮寄地址为寄宿学校请包括学校名称
FUTURE PL ANS 未来计划
Your answers to these questions will vary for different colleges. If the online system did not ask you to answer some of the questions you see in this section, this college chose not to ask that question of its applicants.根据不同学校以下问题答案会不同。如果在线系统未提示以下问题，该学校没有选择询问该问题。College 学校
Entry Term入学学期: 0 Fal秋季l (Jul-Dec7-12)0 Spring春季 (Jan-Jun1-6) Decision Plan 决定计划 Academic Interests 学术兴趣 Career Interest 职业兴趣
mm/dd/yyyy月日年
Deadline 截止日期 Doyouintendtoapplyforneed-based financial aid?是否申请救济 0Yes是0No否 Doyouintendtoapplyformerit-basedscholarships?是否申请奖学金 0Yes是0No否Do you intend to be a full-time student?是否想成为全日制学生0Yes是0No否 Doyouintendtoenrollinadegreeprogramyourfirstyear?是否第一年就进入学位课程学习0Yes是0No否
Do you intend to live in college housing? 是否住学校宿舍
What is the highest degree you intend to earn? 计划学习的最高学位
D E MOGRAPHI CS 人口信息
Citizenship Status 公民身份 Non-US Citizenship(s) 非美国居民
1. Are you Hispanic/Latino?是西班牙 拉丁裔吗 0Yes, HispanicorLatino(includingSpain)是西班牙或拉丁裔(包括西班牙)0NoIfyes,please describe your background.否，如果是请叙述背景。 Birthplace 出生地 City/Town 城市县 State/Province州省 Country国家 2. Regardless of your answer to the prior question, please indicate how you identify yourself. (Check one or more and describe your background.)无论之前问题的答案，请描述自己（选择一或多项并详述背景） 0 American Indian or Alaska Native (including all Original Peoples of the Americas) 美国印第安人或阿拉斯加本地人（包括所有美国原住民） Years livedintheUS?在美国生活多少年Years livedoutside the US? 美国外生活多少年 Language Proficiency (Check all that apply.)语言熟练程度（适合位置打叉） S(Speak)说 R(Read)读 W(Write写) F(First Language母语) H(Spoken at Home)家乡语 Are you Enrolled注册了吗?0Yes0NoIfyes,please enter Tribal Enrollment Number 若是请输入部落注册码 S R W F H 0Asian(includingIndiansubcontinent and Philippines)亚裔（包括印度附属岛屿及菲律宾） 加勒比人） 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0BlackorAfricanAmerican(includingAfricaandCaribbean)黑人或非洲美国人（包括非洲和0 Native Hawaiian or Other Pacific Islander (Original Peoples) 0 White (including Middle Eastern)白种人（包括中东人） Optional The items with a gray background are optional. No information you provide will be used in a discriminatory manner.选择灰色背景可选，你提供的信息不会被歧视。 Religious Preference 夏威夷本地人或其他太平洋岛民（原住民） US Armed Services veteran status 美国军队服役情况 ©
AP-1 / 2012-13
2012 The Common Application, Inc.
FA MILY家庭
Please list both parents below, even if one or more is deceased or no longer has legal responsibilities toward you. 请列出下面父母双方，即使一个或多个已去世，或已不再向你付法律责任Many colleges collect this information for demographic purposes even if you are an adult or an emancipated minor. 许多高校为统计人口的目的收集这些信息，即使你是一个成年人或已有独立自主能力的未成年人。If you are a minor with a legal guardian (an individual or government entity), then please list that information below as well. 如果您是有法定监护人（个人或政府机构）的未成年人，那么请列出以下信息If you wish, you may list step-parents and/or other adults with whom you reside, or who otherwise care for you, in the Additional Information section. 如果你愿意，你可以列出与您居住的继父母和/或其他成年人，或者谁照顾你，在附加信息部分里列出
Household
Parents’ marital status父母的婚姻状况(relative to each other) （相对于彼此）: 0 Never Married从未结婚 0 Married 已婚 0 Civil Union/Domestic Partners民事联盟/ 家庭伴侣 0 Widowed 丧偶0 Separated分居 0 Divorced离婚(date ) （日期） With whom do you make your permanent home?你想和谁永久居住 0 Parent 10家长10 Parent 20家长20 Both双方0 Legal Guardian法定监护人0 Ward of the Court/State ？法院/国家0 Other其他
If you have children, how many? 如果你有孩子，有多少？
mm/yyyy
Parent 1家长1
0 Mother母亲0 Father父亲0 Unknown未知 Is Parent 1 living?是健在的家长1 0 Yes是0 No否(Date Deceased 已故日期 )
mm/yyyy月/年
Parent 2家长2
0 Mother 0 Father 0 Unknown Is Parent 2 living? 是健在的家长2 0 Yes是0 No否(Date Deceased 已故日期 )
mm/yyyy
Last/Family/Sur First/Given Middle
Last/Family/Sur First/Given Middle
Former last name(s) 曾用名？ Country of birth 出生国家 Home address if different from yours
家庭地址如果与你的不同
Former last name(s) Country of birth Home address if different from yours
Preferred Telephone常用电话: 0 Home 家0 Cell 手机？0 Work？工作电话
Area/Country/City Code地区/国家/地区代码 Preferred Telephone: 0 Home 0 Cell 0 Work (
E-mail Occupation Employer College (if any) Degree Graduate School (if any) Degree ) Area/Country/City Code
E-mail Occupation职业 Employer 雇主 College (if any) 大学（如果有的话） Degree 学位？ Graduate School (if any) 研究生院（如果有的话） Degree 学位？ CEEB Year CEEB Year CEEB Year CEEB Year
Legal Guardian (if other than a parent) 法定监护人（如父母以外）
Relationship to you 与你的关系
Siblings兄弟姐妹
Please give names and ages of your brothers or sisters. If they are enrolled in grades K-12 (or international equivalent), list their grade levels. If they have
attended or are currently attending college, give the names of the undergraduate institution, degree earned, and approximate dates of attendance. If more than three siblings, please list them in the Additional Information section. 请给出你
兄弟或姐妹的名字和年龄，如果他们参加了K-12年级（或等同国际的），列出他们的级别 如果他们曾经或正在上大学，提供本科的名称，学历，入学的大致日期，如果超过三个兄弟姐妹，请在附加信息部分列出他们
Name
Age & Grade
Relationship
Last/Family/Sur First/Given Middle Country of birth 出生国家
Home address if different from yours家庭住址如果与你的不同
College Attended 参加的学校
Area/Country/City Code
CEEB
Dates 日期
mm/yyyy – mm/yyyy
Age & Grade
Relationship
Degree earned 获得或期望的学位
Preferred Telephone常用电话: 0 Home家 0 Cell 手机0 Work工作 ( ) or expected
E-mail OccupationEmployer
职 雇Name
College Attended CEEB Degree earned Dates 业 mm/yyyy – mm/yyyyor expected
Name
Age & Grade
Relationship
主 College Attended CEEB Degree earned Dates College (if any) 学校（如果） CEEB mm/yyyy – mm/yyyyor expected
Degree 学位 Year Graduate
School (if any) 研究生院（如果有） CEEB Year 年 Degree 学位
©
2012 The Common Application, Inc. AP-2 / 2012-13
Have there been any changes to the senior year courses listed on the original School Report? 0 Yes 0 No
Have there been any changes in the applicant’s disciplinary status at your school since you submitted the original School Report? 0 Yes 0 No 0 School policy prevents me from responding To your knowledge, have there been any changes to the applicant’s criminal history since you submitted the original School Report? 0 Yes 0 No 0 School policy prevents me from responding Do you wish to update your original evaluation of this applicant? 0 Yes 0 No
If you responded yes to any of the preceding questions, please attach an explanation.
0 Check here if you would prefer to discuss this applicant over the phone with each admission office.
©
2012 The Common Application, Inc. MR-1 / 2012-1 3
因篇幅问题不能全部显示，请点此查看更多更全内容