ASSUMPTION COLLEGE ATHLETICS

Information Request Form

Thank you for your interest in the ASSUMPTION COLLEGE ATHLETICS PROGRAM. Please fill out the following form and click on the submit button at the bottom. The appropriate coach(es) will be in touch very soon. A copy of your response will be forwarded to our admissions office. They will send along appropriate materials concerning the application procedure.

SPORT(S) Interested

Name: First M.I. Last

Date of Birth: Month Day Year

E-Mail

Address

City State Zip

Telephone (with area code)

Best Time to Call

Mother's Name Father's Name:

High School or Junior College

School Address

School Code

City State Zip

Telephone (with area code)

Coach(es)

Telephone(s) (with area code)

Position(s)

Height Weight

Last Season Stats

Last Season Honors

ACT Scores SAT Scores Class Rank

Expected Date of Graduation

Grade Point Average

Desired Major

Do you plan to live on campus? Yes No Undecided

Have you registered with the NCAA Clearinghouse? Yes No

Questions or Comments? Send us an e-mail at merc@assumption.edu

Please double check your entries to make sure they are correct.

 

DEPARTMENT OF ATHLETICS

Assumption College, 500 Salisbury Street, Worcester, MA 01609-1296

Main Office (508) 767-7279

Fax (508) 798-2568