NCAA Division III
Intercollegiate Athletics Interest Form

We are pleased that you are interested in Birmingham-Southern College. If you have an interest in competing in NCAA Division III intercollegiate athletics, please complete and submit this form as soon as possible.

Personal Information:
Last Name:		First Name:
Street Address:
City:		State:	ZIP:
Home Phone:		E-Mail:
Sex:	M F	Height:
Weight:		Dominant Hand:	L R
High School:		Graduation Year:
What other colleges are you considering?


SAT:
Verbal: Math: Composite:

ACT:
Composite:		Class Rank:

For Transfer Students:
What is your current college/university?

Athletics Information
Sport No. 1:		Years Lettered:
Position/Events:
High School Coach and Phone Number
Awards, Honors, or Statistics/Event Times (pertinent to an evaluation of your performance):


Sport No. 2:		Years Lettered:
Position/Events:
High School Coach and Phone Number
Awards, Honors, or Statistics/Event Times (pertinent to an evaluation of your performance):

Contact us at:

Admission Office
205/226-4696
toll-free 800-523-5793, ext. 4696
fax 205/226-3074
www.bsc.edu/admission

Intercollegiate Athletics Office
205/226-4935
toll-free: 800-523-5793, ext. 4935
fax 205/226-3049
www.bscsports.net