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Athletic Interest Form
This form requires Javascript to be enabled for submission and authorization.
*
Required
Student Contact
Student Name
*
required
First Name
Last Name
Address
Date of Birth
*
required
mm/dd/yyyy
Student/Family Email
*
required
Phone
*
required
Home Address
Gender
Male
Female
School Information
Name of Current School
*
required
Current grade
*
required
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
Your Academic Average at Current School
Applying for grade
*
required
9th Grade
10th Grade
11th Grade
Proposed year of entry
*
required
Applying for
*
required
Boarder
Day
Undecided
Select all the tests taken
SSAT
PSAT
SAT
Not taken taken
Enter SSAT overall test percentile
0 to 100
Enter PSAT overall test percentile
0 to 100
Enter SAT overall test percentile
Athletic Information
Your Favorite Sport
*
required
Alpine Skiing
Baseball
Basketball
Crew
Cross Country
Dance
Field Hockey
Football
Golf
Ice Hockey
Lacrosse
Nordic Skiing
Soccer
Squash
Tennis
Track & Field
Volleyball
Wrestling
Position Played in that Sport
*
required
Jersey Number
Current Team Name
Current Coach's Phone Number
Current Coach's Email
List achievement or relevant statistics in that sport (please be as specific as possible):
Your 2nd Favorite Sport
Alpine Skiing
Baseball
Basketball
Crew
Cross Country
Dance
Field Hockey
Football
Golf
Ice Hockey
Lacrosse
Nordic Skiing
Soccer
Squash
Tennis
Track & Field
Volleyball
Wrestling
Position Play in that Sport
Jersey Number
Current Team Name
Current Coach's Phone Number
Current Coach's Email
List achievement or relevant statistics in that sport (please be as specific as possible):
Your 3rd Favorite Sport
Alpine Skiing
Baseball
Basketball
Crew
Cross Country
Dance
Field Hockey
Football
Golf
Ice Hockey
Lacrosse
Nordic Skiing
Soccer
Squash
Tennis
Track & Field
Volleyball
Wrestling
Position Play in that Sport
Jersey Number
Current Team Name
Current Coach's Phone Number
Current Coach's Email
List achievement or relevant statistics in that sport (please be as specific as possible):
Other
Have you scheduled a visit to Middlesex?
Yes
No
If yes, when is/was the visit?
Must contain a date in M/D/YYYY format
Have you received Middlesex Admissions Material?
Yes
No
Additional questions or comments:
Other schools that you are considering:
Submit