This form must be printed out, signed and mailed.

Name of Student:
Name while attending high school, if different:
Student's Current Address
City, State, and Zip:
Name of High School:
School's Street Address:
City, State, and Zip:
Date of Graduation (Month/Year):
Social Security Number:
Date of Birth:
Expected Start Term at National American University:

Instructions to the Student: Please print this form and have your high school official fill out the bottom half.

Student's Signature:   _____________________________

TO HIGH SCHOOL OFFICIAL:

Please sign, date and return this entire form along with the student's transcript. If a name change has occurred, please note it on the  transcript before sending it to:

Admissions Office
National American University
321 Kansas City Street
Rapid City, SD  57701

___ If student is currently attending  high school, please send transcript to date for admission consideration.
___  This student owes a financial balance of $_____________________
___ The final  transcript of this student is enclosed.
(Please show graduation data, class rank, ACT or SAT scores and final GPA.)
___ Other: ________________________________________________
 

Signature: _______________________________________

Date: ___________________________