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Parent/Guardian Contact Information
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Last Name: *
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Relationship: *
Father
Mother
Alternate
Step Mother
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College Attended:
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Work Phone:
Extension:
Parent/Guardian Contact Information
First 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
Home Phone:
Mobile Phone:
Email:
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College Attended:
Employer:
Occupation:
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Extension:
Athletic Information
Primary Position:
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Number of Years Played:
1 mile time: *
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50 YD Time: *
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Height: *
ft.
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Weight: *
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Athletic Honors:
Club Team Information
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UT
VT
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WV
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NT
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ON
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UN
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VI
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Zip Code: *
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Phone: *
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Website:
Club Coach Information
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Title:
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Home Phone:
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School Information
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MS
MO
MT
NE
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NJ
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NY
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ND
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OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
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AB
AE
BC
DC
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NB
NL
NS
NT
NU
ON
PE
QC
SK
UN
YT
PR
VI
*Required
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Phone:
Fax:
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Title: *
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Academic Information
GPA: *
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Grad Year: *
2020
2021
2022
2023
2024
2025
2026
2027
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2030
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Class: *
High School
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Class Rank:
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SAT Math:
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Academic Honors:
Registered with Clearinghouse: *
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Clearinghouse ID #:
Intended Major:
1st College Preference:
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