Viterbo

SID Student-Athlete Questionnaire

SID Student-Athlete Questionnaire

The Viterbo University Sports Inforamtion Office requests the following information from you as a candidate for a Viterbo University intercollegiate athletics team. By providing any of the information requested, you are thereby giving consent for its use in appropriate fashion by the Sports Inforamtion Office and the constituent groups served by the Sports Information Office.

  • Name *
  • Date of Birth * / / Pick a date.
  • Permanent Home Address *
     
  • Cell Phone Number - -
  • please note if parents divorced or if a parent is deceased

  • Parents Address
     

    List address if different then one listed above

  • Today's Date * / / Pick a date.
 
 
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