CONTACT INFORMATION
*Full Name:
First Name
Middle Name
Last Name
*Home Address:
Street
City
State, Zip Code ,
Country
Temporary Address (if applicable):
Street
City
State, Zip Code ,
Country
*Home Phone:
Cell Phone - Alternate Phone (if applicable):
*E-Mail:

PERSONAL INFORMATION
Height:
Weight:
*Date of Birth:
Mother's Name:
Father's Name:
Why are you interested in UNH:
List top five schools you are looking at:

ACADEMIC INFORMATION
*Anticipated High School Graduation Year:
Semester & Year in which you plan to attend college : Fall Spring Year
Intended Studies:
High School or Junior College:
School
Street
City
State, Zip Code ,
Country
Guidance Counselor:
Test Scores:
PSAT Math
PSAT Verbal
Date Taken
SAT Math
SAT Verbal
Date Taken
ACT English
ACT Math
Date Taken
GPA:
Class Rank:
Academic Honors:

ATHLETIC INFORMATION
Which team do you compete on:
If applicable, which position do you play:
Name and number of Coach as a reference:
Coach Name
Coach Daytime Number
Coach Home Number
Coach Cell Number
Team/Affiliation
Name and number of Coach as a reference:
Coach Name
Coach Daytime Number
Coach Home Number
Coach Cell Number
Team/Affiliation
Have you initiated the process with NCAA Clearinghouse: Yes No
Do you have a videotape available for the coach's viewing: Yes No
General Athletic Information:
 Please list any information pertinent to your sport, i.e. club teams you play for, statistics, awards/honors, results, etc.

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