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PSU Athletics Information 2014-15

Email address *
First name *
Last name *
Address 1 *
Address 2
City *
State *
ZIP Code *
Plymouth State ID # *
Today's Date *
PSU Sport(s): *
List all sports you plan to try out for
Common Name *
Used in press releases or by announcers; i.e Thomas, Tom or Tommy; Susan, Sue, or Suzie, etc.
Gender *
Height *
Weight
Athletic Year *
(Number of years competing at collegiate level)
Academic Year *
PSU Major(s) *
(Include Undeclared)
PSU Minor
Birth date *
Local Address *
(Residence Hall & Room Number or Street & Apt. Number)
PSU email address *
(name@plymouth.edu)
Cell Phone # *
Parents/Guardian First and Last Names *
Parent/Guardian Address(es) *
(Street Address, City, State, Zip, Country (if not USA)
Parent Home Phone Number(s) *
Parents Cell Phone Number(s)
Emergency Contact *
(Name and Relationship)
Emergency Contact Phone Number *
Second Emergency Contact
(Name and Relationship)
Second Emergency Contact Phone Number
Ethnicity
Citizenship
High School *
(Name)
High School location *
(City, State)
High School Graduation Year *
Are you a transfer student? *
(All 2-year and 4-year schools, including community colleges)
If Yes, Name all schools attended
(Name years and number of semesters attended for each school)
If Yes, Name all schools you participated in Athletics
(Name the sport and years played for each school)
Daily Hometown Newspaper *
(Newspaper Name)
Daily Hometown Newspaper Location *
(City, State)
Weekly Hometown Newspaper
(Newspaper Name)
Weekly Hometown Newspaper Location
(City, State)
* = required field