2011 Athletics Pre-Season Registration Form

Please note fields marked with an * are required.

Personal Information

First Name *   Last Name *
Address: *
City: * State: *
    Zip: *
Email address: *
Home Phone:  *    
Cell Phone: *    
Gender: Male Female
Team: * Field Hockey Soccer Volleyball
  Football Women's Tennis

School Information

Class as of September 2011: Freshman Sophomore
  Junior Senior
Campus you are registered for classes: Leicester Worcester
Living Arrangements: Resident or Commuter
   If Resident, what Resident Hall?  *  

For Entering Students Only

Year of High School Graduation: *
If you graduated prior to 2011 did you participate in organized athletic competition? No    yes
* Are you a transfer student? No    yes
   If yes, which institution did you attend last?
How many semesters?
Did you participate in any varsity or sub-varsity sports at another college? No     yes
   If yes, which sports?
* Are you a U.S. Citizen? No      yes
* Age as of 9/1/11