Student-Athlete Interest Form

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Email address *

First name *

Last name *

Address 1 *

City *

State *

ZIP Code *

Cell Phone Number

Date of birth *

High Shool/Previous School

Present school *

Graduation date *

(Month/Year)

City

State

Position/Positions Played

Please list your events competed in and best Stats/Times

(For Track & Field/Swimming)

Height

Weight

(Optional)

Level of Experience

(College, JC, Club, HS: Varsity, JV, Freshman)

Club/AAU Experience

(If any)

Other Sports Played

(If any)

Athletic Accomplishments

(Ex: All-Conference, Championships, Team Awards)

Recruiting Profile or Highlight/Game Film link

(If available)

Relatives who have attended Modesto Junior College

I agree that I made first contact with the Modesto Junior College Pirates *

Agree

* required field