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Personal Information
First Name: *
Grad Year: *
2020
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Middle Name:
School Name: *
Clear
Last Name: *
Email: *
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Address: *
City: *
State: *
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Zip: *
Date of Birth: *
Mobile/Alt. Phone: *
Academic Interest/Intended Major:
Parent/Guardian Contact Information
Guardian 1 Name: *
Last Name: *
Relationship: *
Father
Mother
Alternate
Step Mother
Neighbor
Uncle
Sister
Grandfather
Guardian
Aunt
Friend
Step Father
Brother
Grandmother
Coach
Other
Spouse
Parent
Girlfriend
Boyfriend
Child
Guidance Counselor
Wife
Cousin
Husband
Club Director
Step Sister
Step Brother
Athletic Director
Phone: *
Mobile Phone:
Email:
College Attended:
Occupation:
Employer:
Work Phone:
Ext:
Parent/Guardian Contact Information
Address (if different than the PSAs):
Do you live with this person? (2):
Siblings (Name & Age):
Parent/Guardian Contact Information
Address (if different than the PSAs):
Do you live with this person? (1):
Parent/Guardian Contact Information
Guardian 2 Name: *
Last Name: *
Relationship: *
Father
Mother
Alternate
Step Mother
Neighbor
Uncle
Sister
Grandfather
Guardian
Aunt
Friend
Step Father
Brother
Grandmother
Coach
Other
Spouse
Parent
Girlfriend
Boyfriend
Child
Guidance Counselor
Wife
Cousin
Husband
Club Director
Step Sister
Step Brother
Athletic Director
Phone: *
Mobile Phone:
Email:
College Attended:
Occupation:
Employer:
Work Phone:
Ext:
Parent/Guardian Contact Information
Guardian 3 Name: *
Last Name: *
Relationship: *
Father
Mother
Alternate
Step Mother
Neighbor
Uncle
Sister
Grandfather
Guardian
Aunt
Friend
Step Father
Brother
Grandmother
Coach
Other
Spouse
Parent
Girlfriend
Boyfriend
Child
Guidance Counselor
Wife
Cousin
Husband
Club Director
Step Sister
Step Brother
Athletic Director
Phone: *
Mobile Phone:
Email:
College Attended:
Occupation:
Employer:
Work Phone:
Ext:
Parent/Guardian Contact Information
Athletic Information
Height:
ft.
in.
Weight:
Position:
Jersey Number:
Other Sports Played:
Your Coach:
Select your head coach
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HS Coach Name:
Coach Cell Phone:
Coach Email: