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| Phone: [Please include the area code] | |
| E-mail: | |
| Street Address*: | |
| City/Town: | |
| Province/State*: | Other: |
| Postal/Zip Code: | |
| Country*: | Other: |
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| Academic Average: Grade: | |
| Graduation Date [mm/yyyy]: | |
| Academic Interest at Mount Allison: | |
| Have you applied to the Mount Allison University yet? | |
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| Sport(s) of interest: | |
| Position: | |
| Height:[in feet-inches] Weight:[in pounds] | |
| School/Team or Club: | |
| Coach: Coach's Phone: [Please include the area code] | |
| Coach's Email: | |
| Comments:[Background/Biography/Awards Won...] | |