Personal Information
Name: Date of Birth: Year of Graduation:
Address: City: State: Zip:
Home Telephone: Cell Phone:
Athlete's E-mail Address:
Family Information
Father’s Name (legal guardian):
Mother’s Name (legal guardian):
Father’s Email Address: Father’s Cell:
Mother’s Email Address: Mother’s Cell Phone:
Father’s Occupation: Mother’s Occupation:
List Siblings & Ages:
Academic Information
Name of High School or Junior College:
School Address:
City: State: Zip:
School Phone: Academic Counselor:
ACT Score: Date ACT Taken: SAT Score: Date SAT Taken:
Class Rank: Cumulative GPA: Intended College Major:
Athletic Information
List Varsity Sport/s You Wish to Play at JWU:
List Position/s You Play:
List Most Recent Stats: Height: Weight:
High School/College (if transfer) Coach’s Name: Contact Phone:
High School/College (if transfer) Coach’s E-mail Address:
Summer Club Team Name: Club Coach:
Club Coach Phone: Club Coach Email Address:
A representative from the Department of Athletics will contact you shortly after submitting this form.
