Recruitment Form For Volleyball

Download and print the recruitment form in Adobe .pdf format or fill out the form below.

First Name:
Middle Initial:
Last Name:

Graduation Month:

Graduation Year:

Address:

City:		State:
Zip:
Phone:		E-mail:
IM Name:
Birth Date:		Age:
SS#:
Nickname:

Height:	feet inches
Standing Reach:	feet inches
Block Jump:	feet inches
Approach Jump:	feet inches
Shirt Size:
Shorts Size:

Mother's Name:
Mother's Occupation:
Father's Name:
Father's Occupation:

High School Address:

High School Phone:
Class Ranking:		Class Size:
GPA:		SAT:
NAT'L ACT:
Qualify for Financial Aid?	Yes	No
NCAA Clearing House?	Yes	No

EXPERIENCE INFORMATION

(choose one)

HIGH SCHOOL	JUNIOR COLLEGE
Team Name:
Uniform Number:		Position:
Coach's Name:
Coach's Phone:
Coach's E-mail:
Club Team:
Uniform Number:		Position:
Coach's Name:
Coach's Phone:
Coach's E-mail:

ACTIVITIES, FUTURE OUTLOOK

Years of Volleyball:		Club:
USA Programs:

Individual Honors:

Team Record/Accomplishments:

Intended area(s) of study:

Career Objectives:

Extracurricular Activities/Interests/Hobbies:

Top 4 college choices:

PLEASE MAIL YOUR STATISTICS AND A DVD/VHS TAPE OF SKILLS/GAME FOOTAGE TO:

Mesa State Women's Volleyball

Attn: Maggie Chlebana

1100 North Avenue

Grand Junction, CO 81501

Dave Fleming
970-248-1362 Office
970-361-7705 Cell
970-248-1980 FAX
dfleming@mesastate.edu

Maggie Chlebana
970-248-1264 Office
970-248-1980 FAX
mchleban@mesastate

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