1. Personal Information

Name: _______________________________________

Parent's Name(s):__________________________



Address: _____________________________________

Parent Email Address: _____________________

City, State Zip Code

Student Email Address: ____________________

Phone #: _____________________

Date of Birth:__________

Grade in Fall: ______

High School Attending in the Fall


Math Course(s) you are taking in the Fall


Science Course(s) you are taking in the Fall


List all activities that you will be involved in during the upcoming school year that may require you to meet on Saturdays (e.g. work, sports, clubs, SAT testing, etc.)


2. Report Card

Include a copy of your latest school report card.

3. Send all items to:

P.O. Box 493
Lincroft, NJ 07738

Your Application must be received no later than July 13th

Do not write below For Official PACE Use Only
Date Received: ____________________________ Application Acknowledgment:____________________________
Essay Included: Y___________ N____________ Final Notification: ______________________________________
Transcript Included: Y_______ N____________ Registration Fee Included: Y ____________ N __________
Recommendation Included: Y_______ N____________
Disposition: I______ A______ R _____ W____ Registration Fee Acknowledgment: Y ___________ N________
Interview Date/Time:__________________________