Date________________
Directions to Applicants:
1. Type or print answers to all questions.
2. Your scholastic record should be submitted by your guidance counselor.
3. Submit one letter of recommendation from a classroom teacher.
4. Submit an essay on how you have prepared for college, what you expect to gain 
   from the college experience and what you hope to contribute to society.
5. Deadline for the application is April 15.
6. Mail to: Lorraine Astemborski, 1115 Mohegan Rd., Schenectady NY 12309  

Name_________________________________________   Telephone______________


Address______________________________________________________________


Date of Birth: ________________

I have attended the following high schools:
Name of Institution                  Location                             Year




What extra-curricular school activities have you been active in during your four 
years of high school? (List offices you have held.) Use extra sheet if necessary.











In what community activities have you participated?











                                                                                        
Signature of applicant ________________________________________