*Last Name:  *First Name:
 Home Address
 *Street Address:  *City:
 *State (US):  *Zip Code:
 Telephone Number
 *Area Code:  *Telephone Number:
 (e.g. 555-5555)
 *E-mail Address:  Parent's E-mail Address:
 Date of Birth:
 (mm/dd/yyyy) 		 Mother's Name:
 Father's Name:  Guardian’s Name:
 (If necessary.)
  High School Information:
 *High School Name:  *High School
 Graduation Year:
 High School
 Grade-Point Average:		  Class Rank: out of
 Academic Honors:
 Have You Taken the SAT?

 Yes No SAT Date:
(mm/dd/yyyy)
 SAT Critical Reading Score:
  SAT Math Score:
 If you have not taken the

 SAT, have you taken the

 PSAT?
 Yes No PSAT Date:
(mm/dd/yyyy)
 PSAT Critical Reading Score:  PSAT Math Score:
  Athletic Information:

 If you are interested in competing in multiple sports, submit one form per sport

 *What sport are you interested in competing in at
 Springfield College?
 Position/Event on your high school team:
 Height:

  Weight: lbs.
 High School Coach’s Name:
 Current Statistics/times:
 Career Statistics/times:
 Athletic Awards:
 Club or AAU Team Name:
 Club or AAU Team Coach’s Name:
 Summer League Team Name:
 Summer League Team Coach’s Name:
 What sports do you compete in at high school?

  Further Information:
 *Are you interested in attending Springfield College as a freshman or as a transfer student?
  Freshman Transfer

  If you selected Transfer, type the school you are currently at here:   

 † NCAA regulations prevent coaches from calling or communicating with transfer students until the current
  institution the prospect attends grants us permission to do so.
 *What is your intended major?
 

 *Are you interested in receiving information and/or application from Springfield College?
   Information Application

 What other colleges are you considering?


 What other colleges have contacted you?


 Do you have a video available of one of your athletic events? Yes No

 Have you ever visited Springfield College? Yes No

 Is there anything else you'd like us to know about you?
 For example, your time in the 40-yard dash; your USAG Gymnastics level; your scores or times in specific events?


Submitted: 02/10/2012 07:48 PM