SPORT:
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TODAY'S DATE (mo/day/yr):
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FULL NAME (first, middle, last):
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YR. OF ELIGIBILITY (Fr.,So.,Jr.,Sr.,Grad.):
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HEIGHT:
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WEIGHT:
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POSITION/EVENT(S):
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NAME YOU PREFER USED IN PUBLICATIONS:
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LEFT/RIGHT HANDED:
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PERMANENT ADDRESS:
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PHONE 1:
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PHONE 2:
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CELL PHONE:
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CAMPUS ADDRESS:
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ROOM PHONE NO.:
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E-MAIL ADDRESS:
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INTENDED MAJOR:
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BIRTHDATE:
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AGE:
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NICKNAME:
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BIRTHPLACE (CITY, STATE):
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IF DIFFERENT THAN BIRTHPLACE, WHAT DO YOU CONSIDER YOUR HOMETOWN (CITY, STATE):
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MOTHER'S FULL NAME:
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FATHER'S FULL NAME:
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PARENTS' ADDRESS (if different than above):
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| BROTHERS (names & ages): |
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| SISTERS (names & ages): |
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HIGH SCHOOL GRADUATED FROM (name of school, city, state, team nickname/mascot):
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POST-GRADUATE YEAR (name of school, city, state, team nickname/mascot):
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HIGH SCHOOL COACH (first & last name):
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HIGH SCHOOL ATHLETIC HONORS (please include: 1) team and/or individual honors, 2) team and/or individual championships and 3) pertinent statistics from each year:)
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OTHER HIGH SCHOOL SPORTS IN WHICH YOU FORMALLY COMPETED: (position? if track & field or swimming, which events?):
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HIGH SCHOOL ACADEMIC HONORS (Honor Society, scholarship, class rank, GPA, etc.):
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DO YOU PARTICIPATE ON A CLUB TEAM OR IN A SUMMER LEAGUE? (List club names & years participating, do not abbreviate):
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DO YOU BELONG TO ANY CAMPUS GROUPS OR CLUBS? (List club names & years participating, do not abbreviate):
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OTHER INTERESTS OR HOBBIES (other sports?):
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POST COLLEGE PLANS OR CAREER ASPIRATIONS:
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DO ANY FRIENDS OR RELATIVES COMPETE IN INTERCOLLEGIATE/PROFESSIONAL SPORTS? (If yes, list name(s), sport(s), team(s):
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IMPORTANT! LIST PREFERRED HOMETOWN NEWSPAPERS (city & name of paper and, if known, name of local reporter who covered your high school career):
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| PLEASE READ THE FOLLOWING AND CHECK THE BOX IF YOU AGREE: |
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| I hereby give the GW Athletics Communications Department permission to review my official transcripts in order to evaluate my candidacy for academic-related athletic honors. I also authorize the GW Department of Athletics to use my name and likeness, and any information contained on this form, in news releases, publications and on the Internet for the purpose of advertising or promoting The George Washington University, GW Athletics, specific GW teams and athletic support organizations. By checking the box below, I agree to the above conditions and certify that all information contained herein is true and accurate. |
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Check this button if you agree:
Agree. |
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