Personal Information

Name:
E-MAIL Address:
Street Address:
City: State: ZIP:
Home phone: Date of birth(mm/dd/yyyy):  
Age: Height:   Weight:
Parent's name(s):

Scholastic Information

School Currently Attending:  
High School Junior College 4 year College/UniversityHigh School
Classification: 5A   4A   3A   2A   1A  Private
Date of your graduation:
Grade point average:   Class rank:
ACT:   SAT:
Intended Major:
Do you qualify for financial aid? Yes No

Athletic Information

Coach:    Coach's phone:
Former School:
Home Town Newspaper:
Events Competed In:
Accompishments in High School:

Accompishments in College:

If NO, contact your guidance counselor, who can obtain materials, at no cost, by calling the Clearinghouse at 319-337-1492. Registration with the NCAA Clearinghouse can also be done at www.ncaaclearinghouse.net. Also, when taking the SAT and ACT, scores can be sent to the clearinghouse by putting the clearinghouse's institution code "9999" in the box when registering to take the tests.