Name:      Date:
Street Address:    Phone:
City:        State:                             Zip:       
Height:  Weight: Birth date:
Parent or Guardian:    Occupation:
High School:   Graduation Year:
Position:   High School Coach:   Office Phone:
Bat: Right Left Switch       Throw: Right Left     Speed Home to First:
Guidance Counselor:   Office Phone:
Approx. GPA in High School:     Expected Major:
Are you seriously interested in attending LCC:
Email Address: