2012-13 First-year Application
For Spring 2013 or perhaps Fall 2013 Enrollment
Lagun Srijana Legal Name ___________________________________________________________________________________________________________________ Last/Family/Sur (Enter name just as it appears on official paperwork. ) First/Given Middle (complete) Jr., and so forth
Preferred term, if certainly not п¬Ѓrst term (only one) ____________________________ 05/07/1996 Birth Date ____________________________________________________ Female Man mm/dd/yyyy
Former last name(s) _____________________________________________ US Social Security Number, if perhaps any ___________________________________ Required for Us residents and Everlasting Residents making an application for financial aid through FAFSA
570 344 7327 570 6775363 Cellular Home (_______) __________________________________ Cell (_______) __________________________________ Area/Country/City Code Area/Country/City Code
E-mail Addresses [email protected] com ________________________________________________ Amount & Streets City/Town County or Parish
IM Address _____________________________________________ _______ Apartment # State/Province Country ZIP/Postal Code
840 clay ave 3 Permanent residence address _________________________________________________________________________________________________ _______ __ Scranton Philadelphia 18510 ____________________________________________________________________________________________________________________________ If unlike above, make sure you give your current mailing addresses for all entry correspondence. (from ___________ to ___________) (mm/dd/yyyy) Number & Street City/Town County or perhaps Parish State/Province Apartment # Country ZIP/Postal Code (mm/dd/yyyy)
Current mailing address __________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________ In case your current mailing address is known as a boarding college, include brand of school right here: ______________________________________________________________ _ __
Your answers to questions will vary for different educational institutions. If the on the net system would not ask you to response some of the concerns you see from this section, this college selected not to request that question of the applicants. 09/30/2013 College Penn State ________________________________________________________ Deadline ______________________________________________________ mm/dd/yyyy
Do you really intend to submit an application for need-based п¬Ѓnancial aid? Do you intend to make an application for merit-based scholarships? Do you intend to be a full-time student? Will you intend to enroll in a degree plan your п¬Ѓrst year?
Certainly Yes Yes Yes
Zero No Zero No
Decision Plan___________________________________________________ Standard
Science, Mathematics, English, Overall economy, and athletics etc .. Academics Interests _____________________________________________ ____________________________________________________________ ____________________________________________________________
yes Do you really intend to are in college casing? ______________________________
Physician Career Interest_________________________________________________
Bachuler What is the highest degree you intend to gain? _________________________
Citizenship Position ______________________________________________ Non-US Citizenship(s)Non ____________________________________________ _____________________________________________________________ _____________________________________________________________ Birthplace Pathri ________________________________________________________ Jhapa Nepal City/Town State/Province Country
1 . Are you Hispanic/Latino? Yes, Hispanic or perhaps Latino (including Spain) No If yes, please describe your background.
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