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Medaille Athletics

Inquiry Form

First Name:		Last Name:
E-mail:
AIM Screenname:
Address:
City:		Phone (Home):
State/Province:		Phone (Cell):
Zip/Postal Code:
Country:
Male Female

School Information
High School Attended:
Year of Graduation:
Are you a transfer student from another college?	Yes No
If yes, what college did you attend?
Birth Date:

Intended starting date:

Fall 2008
Fall 2009
Fall 2010

Athletic Teams

Baseball
Bowling

Cross Country (Men's & Women's)

Golf (Men's and Women's)

Men's Basketball

Men's Lacrosse

Men's Soccer

Men's Volleyball

Softball

Women's Basketball

Women's Lacrosse

Women's Soccer

Women's Volleyball

Your Coach's Information*

Name:
E-mail:
Phone number:

*Optional

Comments and questions

The NCAA prohibits coaches from sending letters or electronic mail to high school students until after September 1st of their junior year in high school.

This form is not an official college application. Please contact our Undergraduate Admissions office with questions about applying to Medaille.

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Want to know more about becoming a student-athlete at Medaille? Please complete and submit this form.

This allows our coaching staff to get to know you and to answer your questions directly.

email: mavs@medaille.edu

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Medaille Athletics

Inquiry Form

First Name:

Last Name:

E-mail:

AIM Screenname:

Address:

City:

Phone (Home):

State/Province:

AB AK AL AR AZ BC CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MB MD ME MI MN MO MS MT NB NC ND NE NF NH NJ NM NS NT NV NY OH OK ON OR PA PE PR PW QC RI SC SK SD TN TX UT VA VI VT WA WI WV WY YT Other

Phone (Cell):

Zip/Postal Code:

Country:

Male Female

School Information

High School Attended:

Year of Graduation:

Are you a transfer student from another college?

Yes No

If yes, what college did you attend?

Birth Date: