Name (First, Last)

Address

City, State, Zip

Home Phone

E-mail

Fax

Social Security Number

School

School Address

City, State, Zip

Coach

Phone (Coach)

E-mail (Coach)

School Counselor

Father's Name

Father's Occupation

Mother's Name

Mother's Occupation

Brother(s) and Sister(s) - names and ages

Age

Birthday

Height

Weight

NCAA Clearinghouse Registered?
Yes      No

Grade Point Average

Class Ranking

Out of:

SAT Score

ACT Score

Grade in School

Graduation Date

Planned Course of Study

Academic Honors

Hobbies, Interests

What are your goals for collegiate shooting?

Make & Model of Smallbore Rifle/Air Rifle Currently Using

We furnish gear for all our shooters. What additional shooting equipment do you need?

What is your best shooting performance in a competition?

Do you do any physical training?