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Mesa State - Grand Junction, Colorado
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Online Recruitment Form for Football

Thank you for your interest in joining the Mesa State Mavericks. Please complete all the fields listed below as best as you can. All fields must contain data. If a field does not apply to you please enter N/A (not applicable)in the field. If a format is specified (ex. mm/dd/yyyy) in the form, you must follow that format when inputting your information.

First Name:
Last Name:
Nickname:
Home Address:
City:
State:
Zipcode:
Home Phone:
Mobile Phone:
E-mail:
Previous/Current School:
Date of Birth:
Social Security Number:
Father's Name:
Mother's Name:
Who do you live with?
Your Jersey Number:
Your Jersey Color:
Other Sports Played:
Your Coach's First Name:
Your Coach's Last Name:
Height:
Weight:
Positions Played on Offense:



Please use 2 letter abbreviations for each position you played separated by a comma from the following options: QB = Quarterback, RB = Running Back, FB = Full Back, WR = Wide Receiver, OL = Offensive Line, TE = Tight End

Positions Played on Defense:



Please use 2 letter abbreviations for each position you played separated by a comma from the following options: CB = Cornerback, FS = Free Safety, LB = Linebacker, DT = Defensive Tackle, DE = Defensive End
Positions Played on Special Teams:



Please use the following abbreviations for each position you played separated by a comma from the following options: R = Returner, K = Kicker, P = Punter, S = Snapper

40 Yard Dash Time:
Bench Press Weight:
Squat Weight:
Power Clean Weight:
Vertical Jump Height:
SAT Total:
Academic Interests:
Grade Point Average:
ACT:
Class Rank:
Your Guidance Counselor:
Graduation Date:

Please contact recruiting coordinator, assistant coach, Robbie Owens at
970-248-1602 or rowens@mesastate.edu if you encounter any difficulties with this form.
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