FIRST NAME:

LAST NAME:

ADDRESS:

CITY:

STATE:

ZIP CODE:

HOME PHONE:

CELL PHONE:

FAX NUMBER:
(IF YOU HAVE A HOME FAX MACHINE)

EMAIL ADDRESS:

DATE OF BIRTH (mmddyyyy):

INSTANT MESSENGER (AOL):

INSTANT MESSENGER (MSN):

INSTANT MESSENGER (YAHOO):

FAMILY INFORMATION:

WHO DO YOU LIVE WITH?:

HIGH SCHOOL GRADUATION YEAR:

MOTHER'S NAME:

OCCUPATION:

MOTHER'S ALMA MATER:

FAMILY AT UofA:

FATHER'S NAME:

OCCUPATION:

FATHER'S ALMA MATER:

SIBLINGS:

FRIENDS AT UofA:

SCHOOL INFORMATION:

SCHOOL NAME:

COACH'S NAME:

GPA:

CORE GPA:

SAT:

ACT:

YOUR ACADEMIC INTEREST:

ATHLETIC INFORMATION:

HEIGHT:

WEIGHT:

40:

JERSEY NUMBER:

POSITION:

SCHOOLS YOU ARE INTERESTED IN: