Personal Information

Last name:      First Name:       Middle Initial:

Mailing Address, Street:     

City:    State:        Zip or Postal Code:

Home Phone Number:  Area Code Number  
   
Cell Phone Number:  Area Code Number

Your E-mail Address: 

Age:       Date of Birth (mm/dd/yyyy):       Height:       Weight: 
 

Name of Parent/Guardian: 

     Occupation: 
 Father

     Occupation: 
 Mother

Address of Parent/Guardian 
(if different from above)

Scholastic Information

High School:       City: 

Date of Graduation:       Cumulative High School Grade Point Average: 

What is your intended major field of study? 

What is your long-term occupational goal?  

Do you anticipate qualifying for a Pell Grant or other Financial Aid Programs?
Yes     No     Not Sure

Athletic Information

Primary Position:       Secondary Position: 

Bat:  Right     Left     Switch          Throws:  Right     Left

High School Coach:       Coach's Phone: 

Summer/Fall Coach:       Coach's Phone: 

Speed:  60 yds     Radar gun: mph