PERSONAL DATA
First Name Middle Name/Initial Last Name Street Address City State County Zip/Postal Code Home Phone Other Phone E-Mail Date of Birth
Gender Male Female U.S. Citizen Yes No
NCAA Clearinghouse Registered? Yes No
ACADEMIC DATA
High School Street Address City State Zip/Postal Code Team Name Coach's Name Phone Athletic Director's Phone Name School's Athletic Dept. E-Mail
Address of School's Web Page (URL)
School's Fax Number H.S. Graduation Year
Intended College Major
Intended College Division Level (eg. NCAA Division 1 or 2)
GRADE LEVEL
Overall Grade Point Average (on a 4.0 scale) Freshman Sophomore Junior Senior
PSAT SAT ACT
High School Academic Honors and Achievements
Extracurricular Interests
ATHLETIC DATA
Height ' " Weight LBS. Vertical Leap "
40 Yard Dash Dominant Foot
High School League Name Shoe Size
Other High School Sports Played
High School Population (all grades) High School Division
Positions Played Frontline Midfield Defender Goalkeeper
High School Athletic Honors and Awards
Club Team Name City
Club Coach's Name Phone
Club Honors and Awards
HIGH SCHOOL SPORTS STATISTICS
FRONTLINE/MIDFIELDERS/DEFENDERS #Games So. Jr. Sr. Games Started So. Jr. Sr. Goals So. Jr. Sr. Assists So. Jr. Sr.
GOALKEEPERS
#Games So. Jr. Sr. Games Started So. Jr. Sr. Shutouts So. Jr. Sr. Goal Allowed So. Jr. Sr. Saves So. Jr. Sr. Dominant Hand So. Jr. Sr.
CLUB SPORTS STATISTICS
College Bound Athletic Connection (CBAC) will not edit the video provided.
Up to the first 60 seconds will be compressed and added to your web page.
Up to the first 5 minutes will be compressed and sent on a CD-ROM with the mailings of member profiles packages discussed below.
Submitted video tapes or other video sources become the property of CBAC.
Please attach a label on the video tape provided and include your name, address, phone number, position, jersey number, date submitted and uniform color.
Edit the video intended for the coaches and recruiters to include specific footage of your performance. Use good quality tape, avoid adding music. Show close up footage of your specific skills along with game situation footage.
OPTIONAL MAILING OF MEMBER'S PROFILES TO 10 UNIVERSITIES
After visiting www.gocollegebound.org links to colleges and universities, please enter below your top choices (up to 10) that you wish to mail an introductory letter your personal profile and your sports video film or CD-ROM to. More mailings may be arranged by contacting College Bound Athletic Connection.
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MAIL MEMBER APPLICATION & PAYMENT TO ADDRESS BELOW
BLUE PACKAGE
*$ 99.00 Picture & profile on members own web page.
SILVER PACKAGE
*$ 169.00 WebPages & 10 mailings of picture, profile & 5 minute CD-ROM sport highlight video clip.
GOLD PACKAGE
*$ 199.00 Picture, profile, 30 second video clip on member's web page & mailings to 15 schools.
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* ANNUAL FEES
I attest that the above information is accurate and I recognize that others, including College Bound Athletic Connection will rely and generally accept this information as accurate. Further, it is recognized that College Bound Athletic Connection will provide this information to interested parties, in several ways including through mailings, over the phone lines, via faxes, the world wide web and internet. The undersigned agrees to hold College Bound Athletic Connection, Christian Sport Camps, Inc., College Bound Summer League, College Bound Services, its affiliates, employees, volunteers and staff harmless, not responsible in any way for the ultimate end use of this information upon its submission and release to the general public. The undersigned knowingly and voluntarily waives and all claims, common law or statutory, past, present, and future, known or unknown, of whatever type, kind or character, and all legally recognizable causes of action, including bodily injury, damage to reputation, or physical harm, including death, against Christian Sport Camps, Inc. College Bound Athletic Connection, College Bound Summer League, College Bound Services, caused or alleged to be caused by the release of this information to third parties.
Please enter package name to confirm for order. Thank You! (BLUE-SILVER-GOLD)
http://www.GoCollegeBound.org