ASSUMPTION COLLEGE ATHLETICS

Information Request Form

Thank you for your interest in the ASSUMPTION COLLEGE ATHLETICS PROGRAM. Please fill out the following form and click on the submit button at the bottom. Your information will be forwarded to the appropriate coaching staff. A copy of your response will be forwarded to our admissions office. They will send along appropriate materials concerning the application procedure.

SPORT(S) Interested:   Please select just One Men's BASEBALL Men's BASKETBALL Women's BASKETBALL Women's CHEERLEADING Men's CROSS COUNTRY/TRACK Women's CROSS COUNTRY/TRACK Men's FOOTBALL Women's FIELD HOCKEY Men's GOLF Men's ICE HOCKEY Men's LACROSSE Women's LACROSSE Women's ROWING Men's SOCCER Women's SOCCER Women's SOFTBALL Women's SWIMMING Men's TENNIS Women's TENNIS Women's VOLLEYBALL

Name: First M.I. Last

Date of Birth: Month Day Year

E-Mail

Address

City State Zip

Telephone (with area code)

Best Time to Call

Mother's Name Father's Name

High School or Junior College

School Address

School Code

City State Zip

Telephone (with area code)

Coach(es)

Telephone(s) (with area code)

Position(s)

Height Weight

Last Season Stats

Last Season Honors

ACT Scores SAT Scores

Class Rank

Expected Date of Graduation

Grade Point Average

Desired Major

Do you plan to live on campus? Yes No Undecided

Have you registered with the NCAA Eligibility Center? Yes No

Questions or Comments?Send us an e-mail at merc@assumption.edu

Please double check your entries to make sure they are correct.