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Men's Tennis Potential Player Form

Please fill out the following form if you are interested in playing intercollegiate tennis
at Illinois Valley Community College. Please mail this form to:

Illinois Valley Community College
Attention:  Men's Tennis
815 N. Orlando Smith Avenue
Oglesby, IL 61348

or email: Julie Milota  sjmilota@gmail.com

Please print or write legibly.

Name:______________________________________________________

Address:___________________________________________________

City/State/Zip Code:___________________________________________

Date of Birth:_____/______/______

Telephone # with Area Code:____________________________________

Cell # with Area Code:_________________________________________

E-Mail Address: ______________________________________________

Parent's Names: _____________________________________________

High School:________________________________________________

City:______________________State:___________Zip Code:_________

Graduation Date:___________

High School Coach:__________________________________________

Coach's Telephone Number: ___________________________________

Player's Information:

Have you taken the SAT?   (    ) Yes   (     ) No      Score________

Have you taken the ACT?  (    ) Yes    (     ) No      Score________

Grade Point Average:_________

I would like to:          ___Schedule a campus visit
                                 ___Be contacted by head coach
                                 ___Other comments that you think the coach should know

You may contact the coach for any other questions, if needed at address above.

*Please note:  Effective Fall 2013 all student athletes will be required to have primary
health insurance.  If you do not have primary insurance, please contact the Head Coach
and he will give you additional information regarding this matter.