Edinboro University of Pennsylvania
Football Office
McComb Fieldhouse
Edinboro University of Pennsylvania
Edinboro, PA 16444
1-800-526-0115
email: pmcmillan@edinboro.edu

Please fill out this form and submit it by clicking the SEND button at the bottom of this page.

PERSONAL INFORMATION
 Date:
Name (first - middle - last):    Nickname:
Home Street Address:
City: State: Zip:
Home Phone #: Cellphone #: Email Address:
Birthdate: Social Security Number:
Father: Occupation: College:
Mother: Occupation: College:
Brothers/Sisters (include ages):
ACADEMIC INFORMATION
High School:
Address of HS (street, city, state, zip):
Guidance Counselor: High School Phone #:
PSAT: SAT: ACT:
Grade Point Average: Class Rank:
Academic Interests (list at least two):
ATHLETIC INFORMATION
Offense Position:
 Defense Position:
 Position Preference in College:
Jersey #: Height: e.g. 5'11" Weight: lbs
Speed in 40 yards: sec Speed in 100 meters: sec Bench Press: lbs
Specialties: Serious Injuries:
Other Sports:
Athletic Honors:
Head Coach's Name: Coach's Home Phone #:
College Your Coach Attended: Coach's School Phone #:
GENERAL INFORMATION
Friends who are students at Edinboro:
(1)
(2)
(3) 		Edinboro Alumni You Know:
(1)
(2)
(3)

Submit this form by pressing the send button: