Name*
Student ID Number*
Date of Birth*
Current Age (years)*
E-mail Address*
Preferred Phone Number*
School Address*
Years in college? (1-5)*
Year started college?*
Did you transfer to Truman?*
If "Yes", what year and from where?
Major
Height (ft and in)
Weight (lbs)
Rugby Shorts Size
Shirt Size
Health Insurance Provider:*
Health Insurance Policy Number*
Parent's Contact Information (REQUIRED)
Parent Name*
Address
City, Sate and Zip*
Phone Number*
Other information - Use the box to provide any additional information about yourself.
Do not fill in the following field
