Front Rush

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General

First Name *

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Middle Name *

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Last Name *

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Date of Birth *

Open the calendar popup.

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How Did You Hear About Piedmont? *

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Player Email Address *

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Home Address1 *

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Home Address2

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City *

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State *

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Zip *

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County *

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Player's Cell Phone Number *

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Instagram *

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Twitter Username

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Facebook Link

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Profile Image

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Emergency Contact Number *

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Background

Primary Guardian's Name *

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Primary Guardian's Relationship *

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Primary Guardian's Phone Number *

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Primary Guardian's Email Address *

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Primary Guardian's Job *

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Secondary Guardian's Name

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Secondary Guardian's Relationship

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Secondary Guardian's Phone Number

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Secondary Guardian's Email Address

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Secondary Guardian's Job

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Siblings *

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Siblings in College *

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Preferred Pronouns

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Academic

Graduation Year *

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High School / College *

School Name

Address1

Address2

Address3

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CEEB Code

the school is not listed above

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County *

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GPA *

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ACT

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SAT

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SAT Critical Reading

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Intended Major *

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Other College Choices *

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Application Process *

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Athletic

Height *

FeetInch

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Recruiting Website

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Youtube Link

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Club Team *

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Club Coach's Name

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Club Coach's Email Address

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Club Coach Cell Phone

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Club Jersey Number *

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Upcoming Tournaments

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High School Coach Name

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High School Coach Email

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High School Coach Cell Phone

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High School Jersey Number *

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Nike Jersey Size *

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Nike Short Size *

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Nike Jacket Size *

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Nike Pant Size *

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Top 5 Jersey # Preferences *

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Personal Contacts

Include any personal contacts you would like to share with this school.These contacts may receive emails, texts or calls for staff at the school.

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Last

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Questionnaires