Student-Athlete Athletic Interest Form:

If you are interested in playing a sport at Jefferson, please complete the form below, contact us at 315-786-2232, or email jwiley@sunyjefferson.edu with any questions.

General Information:  
Full Name:
Street Address:
City:
State:
Zip Code:
Email Address:
Sex: Male Female
Phone Number:
Parent/Legal Guardian:  
Full Name:
Phone Number:
Address: My parent or guardian's address is the same as mine
Sport:  
Sport Interested In:
Position:
Height:
Weight:
Honors/Awards:
High School:  
School Name:
Graduation Year:
Coach's Name:
Coach's Phone Number:
JCC Information:  
Intended Major:
Minor:
Additional Comments: