Name (First, Middle, Last):          

Home Telephone #:          Cell Telephone #:         

Work Telephone #:            Social Security #:        

Date of Birth:          Age:   

If employed, can you submit verification of your legal right to work in the United States? Yes No

Present Address:         City:   

State:         Zip Code:          

Current School Attending:          Current Grade:   

College Phone # (if different):    

E-mail Address:

Sex:    Male Female    Shorts Size:   Small Medium Large X-Large     T-Shirt Size:    Medium XX-Large Large X-Large

Position(s) Desired: