Required fields in bold

Name

Home Phone

E-mail

Age

Date of Birth

Year of Graduation

Social Security Number

City and State

Zip Code

Father's Name and Occupation

Mother's Name and Occupation

Relatives or Friends at Pepperdine

High School or JC

Address

City, State, Zip Code

GPA

Intended Major

SAT Score and date taken

ACT Score and date taken

Height

Weight

Shoe Size

High School Coaches Name

Phone number

Address

City, State, Zip Code

Email Address

Instructor

Instructor's phone number

Strengths

Weakness

Competitive Scoring Avg.

Avg. Green hit in regulation

Avg. Putts

Up and Down %

Do you have a video of your swing?

List Academic Honors

List Athletic Honors

Top College Choices

Career Goals