Name: ___________________________          Height _____          Weight _______

Address: _______________________________________

Home Phone: ______________________

Cell Phone: ________________________

Email: ___________________________

High School w/ Address: Chamblee Charter High School 3688 Chamblee-Dunwoody Road Chamblee, Ga. 30341

Cumulative GPA: __________     Classification ________

ACT Score: _____  SAT Score (Verbal and Math): ______ 

Registered w/ Clearinghouse ___

Coach’s Name: Curtis Mattair

Coach’s Contact Info: coachmattair@gmail.com        

Event/Personal Best: ________________________

Event/Personal Best: ________________________

Event/Personal Best: ________________________

Event/Personal Best: ________________________

(ATHLETE:  complete & return via email to coachmattair@gmail.com)