'S LEGAL NAME 121 ALSO KNOWN AS LAST THSI MOM CT) LOCAL ADDRESS (4) MAILING ADDRESS " m 1 Fl I I 1 i m ..rer ica. ... SiPiif PAM API. t STATL sr iWI (6) STUDENT'S SOCIAL SECURITY NO. (OPTIONAL) 16) HOME PHONE NO. (7) I f4MALE I SEX F UNaL5 MALE (8) I I RACE W OR MA ALAS