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Athletic Questionaire Form
Please provide the following information:
Name
Mailing address
Phone number including area code
First Name:
(Required)
Middle Initial:
Last Name:
(Required)
Age:
Sex:
Male
Female
Height:
Weight:
Address:
(Required)
City:
(Required)
State:
Select State
New York (NY)
Alabama (AL)
Alaska (AK)
Arizona (AZ)
Arkansas (AR)
California (CA)
Colorado (CO)
Conneticut (CT)
Delaware (DE)
District of Columbia (DC)
Florida (FL)
Georgia (GA)
Hawaii (HI)
Idaho (ID)
Illinois (IL)
Indiana (IN)
Iowa (IA)
Kansas (KS)
Kentucky (KY)
Louisiana (LA)
Maine (ME)
Maryland (MD)
Massachusetts (MA)
Michigan (MI)
Minnesota (MN)
Mississippi (MS)
Missouri (MO)
Montana (MT)
Nebraska (NE)
Nevada (NV)
New Hampshire (NH)
New Jersey (NJ)
New Mexico (NM)
North Carolina (NC)
North Dakota (ND)
Ohio (OH)
Oklahoma (OK)
Oregon (OR)
Pennsylvania (PA)
Rhode Island (RI)
South Carolina (SC)
South Dakota (SD)
Tennessee (TN)
Texas (TX)
Utah (UT)
Vermont (VT)
Virginia (VA)
Washington (WA)
West Virginia (WV)
Wisconsin (WI)
Wyoming (WY)
Postal Code:
(Required)
Country:
United States
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Cote D'Ivoire
Croatia
Cuba
Cyrus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bassau
Guyana
Haiti
Heard Island and Mcdonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kirabati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia, The Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Matinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova, Republic of
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Islands
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and The Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Province of China
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
(Required)
Email:
Telephone:
(Required)
High School:
High School Address:
Graduation Date (MM/YYYY):
Coach's Name:
Coach's Home Phone:
Coach's Work Phone:
Major:
Please select a major
ACCT - Accounting AAS
ADVS - Adventure Sports: Leadership and Management AAS
CEAS - Adventure Sports: Leadership and Management Cert
BAAS - Business Administration (Career) AAS
BADM - Business Administration (Transfer) AS
BITM - Business Information Technology Management AAS
CEBT - Business Information Technology Management Cert
CECK - Commerical Cooking Certificate Cert
CMMA - Communications and Media Arts AAS
CEMA - Communications and Media Arts Certificate Cert
CMPS - Computer Science AS
CRSA - Criminal Justice AAS
CRJP - Criminal Justice AS
CART - Culinary Arts AAS
CEDS - Desktop Support Specialist Cert
CEDR - Drafting Certificate Cert
CEEC - Early Childhood Studies Certificate Cert
ELEC - Electrical Technology AAS
EGRS - Engineering Science AS
FSAAS - Financial Services AAS
for - Forest Technology One
HTMG - Hospitality and Tourism Management AAS
ITCN - Information Technology AAS
ITIS - Information Technology AAS
LBAA - Liberal Arts and Sciences AA
LAMS - Liberal Arts and Sciences AS
MRKT - Marketing AAS
MECH - Mechanical Technology AAS
MUSI - Music AS
NURS - Nursing AAS
CEPM - Precision Machining Certificate Cert
CERB - Radio Broadcasting Certificate Cert
RTVB - Radio-Television Broadcasting AAS
RADT - Radiologic Technician AS
CETA - Teaching Assistant Certificate Cert
vet - Veterinary Science Technology One
Sports Interest:
Please select one or more sports
Baseball - Mens
Basketball - Mens
Basketball - Womens
Bowling - Co-Ed
Golf - Co-Ed
Soccer - Mens
Softball - Womens
Tennis - Mens
Tennis - Womens
Volleyball - Womens
Position(s):
Awards & Recognitions:
GPA:
SAT/ACT:
What's Happening
on Campus
SUNY Adirondack brand launches new era for local higher education
Adirondack Technology Showcase at SUNY Adirondack March 16
Job Discovery 2010 at SUNY Adirondack March 18
Poetry and Storytelling Highlight Spring 2010 ACC Writers Project
College Lecture Series: Lyme Disease March 31
SUNY Adirondack TRiO Upward Bound students attend TRiO Day in Burlington
More...