Personal Info
Last name:               
First name:              
Middle name:             
 
Email address:           
Home phone:              
Street address:          
City:                    
State:                   
Zip code:                
 
Birthdate (mm/dd/yy):    
Height:                   ft. in.
Weight:                   lb.
 
Mother's name:           
Mother's occupation:     
Father's name:           
Father's occupation:     
 
 
Academic Info
High school:             
State:                   
Date of graduation:      
Class rank:               out of
GPA:                     
SAT / ACT score(s):      
 
Have you applied to Queens University of Charlotte? 
Desired field of study:  
Will you apply for financial aid?                   
 
Please list non-athletic activities:

 
Other schools you are considering:

 
 
Athletic Info
High school coach:       
Coach's home phone:      
Coach's work phone:      
Position played:         
Years played:            
Jersey number:           
Do you have a video available?   
Have you registered with the NCAA Clearinghouse?
 
Athletic achievements:

 
Other sports you play (if any):

 
High school lacrosse honors:

Dominant hand: 
 
Goals:      
Assists:
 
Additional comments?

 
Thank you for taking the time to answer these questions!