First Name:     Last Name:

Address:   

City:     State:    Zip Code: 
 
Home Phone:    Cell Phone: 
 
E-mail Address: 
 
Birth Date: 
 
Parent(s) Name:

High School:

Location of High School:

Guidance Counselor's Name:

Guidance Counselor's Phone:

Graduation Date:      GPA:    

Academic Awards:

Other Awards or Positions Held:

SAT Reading:    SAT Math:    SAT Writing:    ACT:

College/Junior College Attended:


Intended Major(s):

Athletic Information

High School Coach's Name: 

High School Coach's Phone: 

Position(s): 

Height:      Weight:

Year(s) of Varsity Play: 

Other Sports Played: 

Athletic Award(s): 

All-Star or Club Team(s): 

Club Coach's Name:

Club Coach's Phone:

Do You Have a Video Available to Send to the Coach: Yes   No