Michigan Volleyball Up Close-

Mark Rosen Head Coach
Office: (734) 647-3035 Cell: (734) 904-2500
E-Mail: rosenma@umich.edu

Leisa Rosen Assoc. Head Coach
Office: (734) 764-5317 Cell: (734) 646-2817
E-Mail: rosenlm@umich.edu

Bold fields are required.

I. Personal

First Name:

Middle Initial:

Last Name:

Nickname:

Street Address:

City:

State:

Zip:

Home Phone:

Cell Phone:
IM Screen Name: Social Security Number:
Church Affiliation: Email:
Birthdate: Birth City: Birth State:
Brother's/Sister's Names/Colleges:

Mother's Name: Mother's Occupation:
Mother's College: Employer: Work Phone:
Father's Name: Father's Occupation:
Father's College: Employer: Work Phone:
Living With: Other: Relationship:

II. Academic

High School:

School Address:
School City: School State: School Zip:
Phone:
GPA: SAT-V: SAT-M: ACT: Class Rank:

Are you interested in Michigan? Yes, Very Much Yes Might Be

Other Colleges you are interested in 1)
2)
3)
4)

Academic Counselor: Counselor's Work Phone:
Academic Honors:

Potential College Major 1) 2)

U of M people you know (past and present):

III. Athletic

Height:

Weight:

Postition:

Preferred Position:

Uniform #:

High School Coach:

Coach's College:
H.S. Coach's Home Phone: Work Phone:

Club:

Club Website:

Club Coach:

Club Coach's College:
Club Coach's Home Phone: Work Phone:
Other Sports:
Injuries:
Athletic Honors:
Standing Reach (inches): Jump Touch (3 step):

IV. Notes Comments:



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