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GENERAL INFORMATION:
First Name:
Middle Initial:
Last Name:
Telephone:
Address:
City:
State:
Zip:
Mother/Guardian:
Occupation:
Business Phone:
Father/Guardian:
Occupation:
Business Phone:
Brothers:
Sisters:
Email Address:
Cell Phone:
Date of birth:
Gender:
Male
Female
ACADEMIC INFORMATION:
Name of High School:
Guidance Counselor:
S.A.T. Scores:
CR:
M:
W:
ACT Score:
Class Rank:
out of
GPA:
Please list your academic interest(s) or major field(s) of study:
Date you will graduate from high school:
Month:
Year:
ATHLETIC INFORMATION:
Height:
Weight:
Event:
Time/Distance/Height:
Event:
Time/Distance/Height:
Event:
Time/Distance/Height:
Event:
Time/Distance/Height:
Event:
Time/Distance/Height:
Event:
Time/Distance/Height:
Coach's Name:
Home Phone:
Office Phone:
Email:
What other varsity sports do you want to play in college?
Friends/relatives attending or graduates of Lebanon Valley: