First Name

(required)

Last Name

(required)

Street Address

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City

State Zip (required)

Telephone

E-mail Address

High School

City

SAT Scores

Total: Verbal: Math:

ACT Scores

Composite: EN: MA: SSR: NSR:

Academic Major

Academic Strength(s)

Academic Weakness(es)

High School Activities

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NOTE: This application is for admission only to the BUILD program. For an undergraduate application for university admission, contact the Office of Admissions at 317-788-3216 or 800-232-8634 or complete the online application at http://admissions.uindy.edu. Do not send university applications to the BUILD program.