Fields marked with * are mandatory
General

First Name *
*Please enter valid First Name
Last Name *
*Please enter valid Last Name
Email Address
*Please enter valid Email Address
Home Address1
*Please enter valid Home Address1
Home Address2
*Please enter valid Home Address2
City
*Please enter valid City
State
*Please enter valid State
Zip
*Please enter valid Zip
Contact Number
*Please enter valid Contact Number
CellPhone Number
*Please enter valid CellPhone Number
Graduation Year
*Please enter valid Graduation Year
Preferred Name
*Please enter valid Preferred Name
SS Number
*Please enter valid SS Number
Background

Parents Married/Divorced/Other
*Please enter valid Parents Married/Divorced/Other
Live With Mom/Dad/Both/Other
*Please enter valid Live With Mom/Dad/Both/Other
Siblings Names/Ages
*Please enter valid Siblings Names/Ages
Number of siblings in College/Where
*Please enter valid Number of siblings in College/Where
Bethany Alumni/Students you know
*Please enter valid Bethany Alumni/Students you know
Academic

High School
School Name
Address1
Address2
Address3
City
State
Zip
Country
CEEB Code
the school is not listed above
*Please enter valid High School
School Main Number
*Please enter valid School Main Number
School Fax Number
*Please enter valid School Fax Number
Guidance Counselour
*Please enter valid Guidance Counselour
GPA
*Please enter valid GPA
Class Rank
*Please enter valid Class Rank
PSAT/SAT/ACT
*Please enter valid PSAT/SAT/ACT
Athletic

Position
































*Please enter valid Position
Recruiting Website
*Please enter valid Recruiting Website
Coach's Name
*Please enter valid Coach's Name
Coach's Phone Number
*Please enter valid Coach's Phone Number
Coach's Cell Number
*Please enter valid Coach's Cell Number
Coach's Home Number
*Please enter valid Coach's Home Number
Coach's Email
*Please enter valid Coach's Email
Height
FeetInch
*Please enter valid Height
Weight
*Please enter valid Weight
Speed (40yds.)
*Please enter valid Speed (40yds.)
School Colors
*Please enter valid School Colors
Jersey Number
*Please enter valid Jersey Number
Other Sports
*Please enter valid Other Sports