Prospective Student-Athletes are invited to complete and submit the form below to indicate their possible interest in attending Mesa Community College. This is not an official application for admission and does not involve a commitment by either party. It will be used by the coach of the appropriate sport for contact purposes only.

*- Required Information 1 Personal Information *Name: *Address: *City: *State: Please Choose --- Arizona --- Alabama Alaska Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming --- Outside USA *Zip Code: *Phone Number: *Email: Date of Birth: Father or Guardian: Occupation: Mother or Guardian: Occupation: 2 Academic Information High School: Address: Phone Number: Coach’s Name(s): Coach’s Phone Number:   Date of Graduation:   Have you ever attended a college or university?: Yes No If YES, give details: Planned Major at MCC: Planned Minor at MCC:   Academic Honors: (and/or other activities participated in)   3 Athletic Information Position Desired: Varsity Baseball letters won: Speed-Home to First (mph): Speed-60 Yard Dash (mph): Height: ft   in Weight (lbs): Bat/Throw: Batting Average: Velocity/MPH: Have you ever been drafted by a professional club? Yes No If YES, give name & date: Significant Statistics : Athletic Honors: (Ex. Captain, All-State, MVP, Etc.) References: Please list full-time major league scouts who have seen you play: Name:   Address:   Phone:   Name:   Address:   Phone:     Comments: