Personal Information:

Last Name:
First Name:
Date of Birth (MM/DD/YEAR):
Address:
City:
Province:	Saskatchewan Alberta B.C. Manitoba Ontario Quebec P.E.I Newfoundland Yukon N.W.T Nova Scotia
Postal Code:
Telephone Number:
E-mail:

Academic Information

High School / CEGEP:
Date of Graduation (MM/DD/YEAR):
Academic Average:
University Program Interests:

Athletic Information

Team / League:
Height:
Weight:
Speed (40 yards):
Bench Press:
Head Coach:
Head Coach's Phone Number:
Positions Played:
Awards Achieved:
Preferred Position in University:

Do you have a video tape (Game tape or Highlight Package) that could be viewed upon request :

NoYes