5 Brain power
Application form
Name: Lourdes Zuaste Gallegos
Date of birth: 11 de febrero de 2009
e-mail: lourdeszuga@hotmail.com
Permanent Home address: Calle Lázaro Cárdenas s/n Col. Linda Vista
Mailing address: C.P. 79120
Nationality: Mexican
Possible area of concentration/major (leave blank if undecided):
Will you apply for financial aid? Yes x No.
List the high Schools you have attended or will graduate from: (name, dates attended, date of graduation):
High School Sec. Técnica # 41 , 2004-2007 generation
List. Any extracurricular activities you have participated in, and for how long:
I’ve being playin’ football about three years
Did you receibe any honors in any of these activities?
Yes, I have received many honors
Do you plan of taking part in any of these activities in college? Yes X No
List any academic honors you have received in high school
1. Honors
2. Awards
3. Scolarships
4. Trophies
Please write a few sentences about an activity o you’ve participated (either extracurrilicular or work related) has meant a lot to you. Explain how it has made an included on your life.
1. I like practice football
2. Participle in the state burnament of sporting
3. Participle in the national tournament of sparting
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