Cal State Fullerton
Student-Athlete
Personal Information

	Print Full Legal Name				Social Security Number

Local Address		City		State		Zip

Local Phone Number (	)				Date of Birth 				

Parent(s) or Guardian’s Name 									

Address (If different from yours)	City		State		Zip

Parent’s Phone # 					Parent’s Work # 				

Roommates Names (print)										
				
Property Manager’s Name and Phone (print) 							

1)  Your year in school     1st      2nd      3rd      4th      5th year

2)  Did you sign a National Letter of Intent to Cal State Fullerton?	 Yes   No

3)  Are you receiving an athletic grant-in-aid?				 Yes   No

4)  Have you applied for institutional financial aid?			 Yes   No

5)	As a recruit: 
a.  	Did you make an official visit to CSF’s campus?		 Yes   No
b.	Did you, your parents, or guardian have an arranged,
in-person, off campus meeting with a coach?			 Yes   No
c.	Did a coach initiate more than one phone call for the
purpose of recruiting you?						 Yes   No

6)  Are you a transfer student?						 Yes   No

	If yes, which school? 						 2 yr.   4 yr.

	Did you sign a National Letter of Intent to that school?		 Yes    No

7)  Are you planning to be employed during the academic year?	 Yes    No

	If yes, indicate:    On-campus	 Off-campus

8)  Are you a:   CA resident	 Non-resident?

9)	Ethnicity:   Asian   African-American   Hispanic   Native American
 Pacific Islander	 White	 Other 				

The above information is truthful and complete to the best of my knowledge.

Signature of Student-Athlete			Date