Prospective Athlete Form

Address

Date of Birth
Parent Name

First Name Last Name
Parent Phone

- Area Code Phone Number
ACADEMIC INFORMATION
High School Name
High School Grad Year
High School City
High School GPA
ACT Score
SAT Score
Have you attended another college/university?

Yes No
List all colleges/universities that you have attended.
What Academic Program / Major are you interested in at MMCC?
ATHLETIC INFORMATION
Sports (mark all that apply)

Men's Basketball Women's Basketball Men's Bowling Women's Bowling Men's Cross Country Women's Cross Country Hockey (Co-Ed)
Position(s) Played
Height
Weight
High School Coach Name
High School Coach Contact Information
Non-School / Travel / AAU Team
Other Coach Name
Other Coach Contact Information
Any other information / highlight reels / links that we should know about?
Should be Empty:

MID MICHIGAN COMMUNITY COLLEGE LAKERS