Fields marked with * are mandatory
General

First Name *
*Please enter valid First Name
Last Name *
*Please enter valid Last Name
Preferred Name
*Please enter valid Preferred Name
Home Address1
*Please enter valid Home Address1
City
*Please enter valid City
State
*Please enter valid State
Zip
*Please enter valid Zip
Home Phone Number *
*Please enter valid Home Phone Number
Cell Phone Number
*Please enter valid Cell Phone Number
Email Address
*Please enter valid Email Address
Date of Birth
*Please enter valid Date of Birth
Background

Mother's Name
*Please enter valid Mother's Name
Mother's Phone Number
*Please enter valid Mother's Phone Number
Father's Name
*Please enter valid Father's Name
Father's Phone Number
*Please enter valid Father's Phone Number
Academic

Graduation Year
*Please enter valid Graduation Year
High School/College
School Name
Address1
Address2
Address3
City
State
Zip
Country
CEEB Code
the school is not listed above
*Please enter valid High School/College
Class Rank
*Please enter valid Class Rank
GPA
*Please enter valid GPA
SAT Total
*Please enter valid SAT Total
ACT
*Please enter valid ACT
Have you applied to ESU?

*Please enter valid Have you applied to ESU?
Athletic

Position(s)




*Please enter valid Position(s)
Height
FeetInch
*Please enter valid Height
Weight
*Please enter valid Weight
HS Coach Name
*Please enter valid HS Coach Name
HS Coach Number
*Please enter valid HS Coach Number
AAU Team Name
*Please enter valid AAU Team Name
AAU Coach Name
*Please enter valid AAU Coach Name
AAU Coach Phone
*Please enter valid AAU Coach Phone
Have you registered with the NCAA Eligibility Cent

*Please enter valid Have you registered with the NCAA Eligibility Cent
If yes, what date did you submit your information?
*Please enter valid If yes, what date did you submit your information?
NCAA Clearinghouse #
*Please enter valid NCAA Clearinghouse #