I hereby certify that I made first contact with Cosumnes River College and that I am requesting information from this college without prior contact by members of the staff or persons representing the college. I also certify that the person named below is also the person filling out this form and submitting it.

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Please provide the following contact information:

*First Name
*Last Name
*Street Address
*Address (cont.)
*City
*State/Province
*Zip
*Country
*Home Phone
E-mail
URL

*Date of Birth
*Sex	Male Female
Height
Weight
ID Number

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Baseball
Men's basketball
Women's Basketball
Men's Soccer
Women's Soccer
Softball
Men's Tennis
Women's tennis
Volleyball
Water Polo