Southwestern University: Alumni: Alumni Referral Form

Present This Card To A High School Student You Think Would Be A Good Fit For Southwestern. Fields marked [*] are required to submit the form. Thanks!

Student Information
Title:
Student Name (First)*:
Student Name (Last)*:
Permanent Address*:
City:
State:
Zip Code:
Date of Birth:
Student E-mail:
Current High School*:
High School City/St:
High School Graduation* (MM/YY):	/
SAT - I Scores:	Critical Reading Math Writing Combined
ACT Composite:
Class Rank:
Grade Average or GPA:
Academic Interest(s):
Special Interest(s):
Referred by
Name of Alumna/us*:
Class Year*:
Preferred Email: