Personal Information
Student Name:	First Middle Last
Preferred Name:
Address:
City:	State:   Zip:
Gender:
Date of Birth:	(mm/dd/yyyy)
Home Phone:	Cell Phone:
Email Address:

Parent Information
Mother's Name:	First Last
Mother's Job:	Work Phone:
Mother's College:	(if any)
Father's Name:	First Last
Father's Job:	Work Phone:
Father's College:	(if any)
I Live With:
If Other - Enter Name:	Relationship:

Academic Information
Present School Type:
Name of School:
Address of School:
City of School:	State:   Zip:
Guidance Counselor:	Email:
School Phone:
Graduation Year	GPA: Class Ranking:
Scores - SAT V:	SAT M: ACT:
Academic Honors:
Planned Major 1:
Planned Major 2:

Athletic Information
Pimary Sport:	Position 1: Jersey Number:
Position 2:	Position 3:
Coach's Name:
Coach's Phone:	Email:
Athletic Honors:
Other Sports:

Physical Information
Height - Feet, Inches:	Weight:
Times - 20:	40: 100:
Lifting - Bench:	Squat: Vertical Jump:
Injuries: