READ BEFORE BEGINNING

Information within this document will be used for emergency contact information and to determine NCAA eligibility in each sport. It will also be used in news releases, brochures, rosters, media guides, programs and on the website.

There are a number of required fields. If the question does not apply to you, please put N/A in the field so you'll be able to submit the form at the end. If you have any questions while filling out this form, please contact the Sports Information Office at 610-861-1472 or sportsinfo@moravian.edu

* designates required fields

The information on this form will be used until August 31, 2018

Please complete this form in proper English form using upper and lower case letters. Also, please use hyphens when writing phone numbers: 123-456-7890.

Basic Information

* Last name
* First name
* Middie initial
* Gender
* Name you prefer to go by (nickname)
* Pronunciation of last name - write phonetically   (example - Eddinger as ED-ing-er)
* Exactly how would you like your name listed
on any certificates and awards?
* Select first sport you anticipate to play this year at Moravian
Select second sport you anticipate to play if any
Select third sport you anticipate to play if any  
* Check current status FR       SO       JR       SR       GRAD
* Date of birth
* Current age
* Month and year you began attending
Moravian College

Contact Information

* Your cell phone # with area code   please use hyphens when writing phone numbers: 123-456-7890
* Campus mailbox #
* Campus address   (Room# & Dorm or House# & Street)
* Your school email address   @moravian.edu
* Your personal email address
* Which email would you respond to more quickly School      Personal
* Your complete home mailing address House/Appt. Number & Street
  City
  State
  Zip Code
* At the address above, do you live with Both Parents      Mother      Father      Guardian      Other
* What county do you live in (not country)   (example - Lehigh, Northampton, Monroe)
* Mother's first name
* Mother's last name
* Mother's email address
* Mother's cell phone number with area code
* Mother's work phone number with area code
* Mother's home phone number with area code
* Father's first name
* Father's last name
* Father's email address
* Father's cell phone number with area code
* Father's work phone number with area code
* Father's home phone number with area code
* If you do not live with both parents, please list the complete home mailing address of the other

If you live with a guardian, please complete the following:
Guardian's first name  
Guardian's last name  
Guardian's cell phone number with area code 
Guardian's work phone number with area code 
Guardian's home phone number with area code 

Eligibility Information

* Last FOUR DIGITS of you social security #
* How many semsters total have you been
enrolled as a full-time student		   (all colleges attended, and including the current one)

What sports have you already participated in at Moravian:
If you are a freshman or transfer, please put N/A in the first box of each line below
* Sport #1       Years Played - FR     SO     JR     SR
* Sport #2       Years Played - FR     SO     JR     SR
* Sport #3       Years Played - FR     SO     JR     SR

Have you attended ANY OTHER colleges besides Moravian?
If yes, complete all sections below. If no, please put N/A in the first box of each line below and go to final section on personal information.
* College #1  
Attended from  
# of full time semesters  
Month/Year to Month/Year
* College #2  
Attended from  
# of full time semesters  
Month/Year to Month/Year
* College #3  
Attended from  
# of full time semesters  
Month/Year to Month/Year

What sports did you play at your previous college?
* Sport #1  
at College  
Played as  

FR     SO     JR     SR
* Sport #2  
at College  
Played as  

FR      SO     JR     SR
* Sport #3  
at College  
Played as  

FR      SO     JR     SR
* Sport #4  
at College  
Played as  

FR      SO     JR     SR

Personal Information

* Career plans
* Your major at Moravian
* Your minor at Moravian
* Current GPA at Moravian
* Have you been on the Dean's List at Moravian
* How many times have you made the Dean's List
Did someone refer you to Moravian College  Yes    No     If yes, list name and relationship
* Position/Event in each sport
Baseball/Softball only Throws:  left      right         
Bats:  left      right      both
* Height
Weight (men only)
* Your hometown newspaper
* Notable family members (pro athletes,
politicians, celebrities, historical, etc.)		   (list name & relationship)
* Relatives who graduated from Moravian   (list name & relationship with graduation year)
* List any academic honors earned at Moravian (or previous schools for transfers)
* List any athletic honors earned at previous schools for transfers
* List any clubs & organizations you participate in at Moravian (include offices held)
* High School
* Do you play on an AAU / summer league team?   (please list name of team & sport)

Freshman Information

High school sport(s) & letters won
High school athletic awards won
Championships won
High school graduation date
High school coaches
Did you set any records in high school

Response Information

FREEDOM OF INFORMATION ACT CLEARANCE
(Failure to sign this form will make it invalid)

I agree to allow the Moravian College Athletics & Sports Information Offices to use the information on this questionnaire for press releases, media guides and biographies to be produced for the Moravian athletics website and for use by the media as well as eligibility information.

If I receive academic awards, I authorize the Moravian Sports Information Office to release my grade point average and major course of study.

* I (Type Full Legal Name) grant permission to Moravian's Athletics & Sports Information Offices to use the information submitted in this form:

* Today's Date:

You will be asked to confirm this form.