BUCKNELL UNIVERSITY
MEN'S LACROSSE

PERSONAL INFO

FIRST NAME  
LAST NAME  
ADDRESS  
 
CITY  
STATE  
ZIP  
HOME COUNTRY  
HOME PHONE  
CELL PHONE  
EMAIL  
DATE OF BIRTH  
SSN  
OTHER SCHOOLS INTERESTED  
SIBLINGS  
LEVEL OF INTEREST FOR BUCKNELL  
WILL YOU BE APPLYING FOR FINANCIAL AID?  

PARENTAL/GUARDIAN INFORMATION

 

Only fill out mother's and father's addresses if they are different than yours.

MOTHER'S FIRST NAME  
MOTHER'S LAST NAME  
MOTHER'S ADDRESS  
MOTHER'S CITY  
MOTHER'S STATE  
MOTHER'S ZIP  
MOTHER'S EMAIL  
MOTHER'S WORK PHONE  
MOTHER'S CELL  
MOTHER'S ALMA MATER  
MOTHER'S OCCUPATION  
FATHER'S FIRST NAME  
FATHER'S LAST NAME  
FATHER'S ADDRESS  
FATHER'S CITY  
FATHER'S STATE  
FATHER'S ZIP  
FATHER'S EMAIL  
FATHER'S WORK PHONE  
FATHER'S CELL  
FATHER'S ALMA MATER  
FATHER'S OCCUPATION  
STEPMOTHER'S FIRST NAME  
STEPMOTHER'S LAST NAME  
STEPMOTHER'S EMAIL  
STEPMOTHER'S CELL PHONE  
STEPMOTHER'S ADDRESS  
STEPMOTHER'S CITY  
STEPMOTHER'S STATE  
STEPMOTHER'S ZIP  
STEPFATHER'S FIRST NAME  
STEPFATHER'S LAST NAME  
STEPFATHER'S EMAIL  
STEPFATHER'S CELL PHONE  
STEPFATHER'S WORK PHONE  
STEPFATHER'S ADDRESS  
STEPFATHER'S CITY  
STEPFATHER'S STATE  
STEPFATHER'S ZIP  

ACADEMIC INFO

HS NAME  

GRADUATION YEAR  
HS ADDRESS  
 
HS CITY  
HS STATE  
ZIP  
HS PHONE  
CLASS RANK  
GRADE POINT AVERAGE  
ACT  
SAT TOTAL  
INTENDED MAJOR  

ATHLETIC INFO

HS COACH'S FIRST NAME  
HS COACH'S LAST NAME  
HS COACH'S EMAIL  
HS COACH'S CELL PHONE  
HS COACH'S WORK PHONE  
POSITION  
HEIGHT  
WEIGHT  
JERSEY NO  
ATHLETIC HONORS  
OTHER SPORTS PLAYED  
CAMPS ATTENDED  
 

CLUB TEAM

CLUB TEAM NAME  
CLUB COACH'S FIRST NAME  
CLUB COACH'S LAST NAME  
CLUB COACH'S EMAIL  
CLUB COACH'S CELL PHONE