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Personal Information
Graduation Year *
First Name * Middle Name
Last Name * Preferred Name
Address *
Address2 * City *
State * Zip *
Clearinghouse ID Email *
Home Phone Cell Phone *
Birth Date *
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Family Information
Father's Name Father's Occupation
Father's Employer Father's Home phone #
Father's Work phone # Father's Cell phone #
Father's Email Father's College
Mother's Name Mother's Occupation
Mother's Employer Mother's Home phone #
Mother's Work phone # Mother's Cell phone #
Mother's Email Mother's College
Parents' Marital Status
I live with If other:
The names and ages of my siblings are:

Athletic Information
Projected Position Off. Pos
Def. Pos Spec. Pos
squat lift 40 yard
bench 200 meter
vertical 100 meter
clean lift 400 meter
Height ft in Weight
Jersey Number Other Sports
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Scholastic Information
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School Name School Address
School City School ZIP
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Counselor's First name Counselor's Last name
Coach's First Name Coach's Last Name
Coach's Email
Coach's Work Phone Coach's Home Phone
Coach's Cell Phone
SAT Math SAT Reading & Writing
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Camp Information
Please select all the days you will be attending camp
Specialist Camp June 17th
June 18th June 19th
June 25th June 26th
July 13th July 14th