Centre College Athletics: Football



	Baseball Basketball Cross Country Football Golf Soccer Swimming and Diving Tennis Track and Field


	Basketball Cross Country Field Hockey Golf Soccer Softball Swimming and Diving Tennis Track and Field Volleyball


Required Fields are red.

Personal Information

Name:

Preferred Name:

Phone Number:

Cell Phone:

Address:

City:

State:	Zipcode:

Date of Birth:

Email Address:

Contact Me Via:

Father's Name:

Father's Occupation:

Father's College Years:

Mother's Name:

Mother's Occupation:

Mother's College Years:

Academic Information

High School:

HS Phone Number:

HS Address:

HS City:

HS State:	HS Zipcode:

Academic Interests:

Extracurricular Activities:

Academic Honors:

ACT:	SAT Critical Reading:	SAT Math:

Retaking?:	Date:

Graduation Year:	GPA:

Class Rank:	out of

Top College Choice 1

Top College Choice 2

Top College Choice 3:

Athletic Information

Position(s):

Height:	Weight:

High School Coach:

Coach's Phone Number:

High School Team and Individual Honors:

Jersey Number:

Number of Years Played (please indicate first team):

Max Bench:	Squat:	40 Yard:

Other Sports Played: