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Athletic Interest Registration

Please first submit a current online Inquiry Form, if you have not done it.

Student contact
Student name: * Required
First Last
Student/family email: * Required
Phone: * Required
Date of birth: - must be mm/dd/yyyy format * Required
MM slash DD slash YYYY
Gender: * Required
- Male
- Female
Address: * Required
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
School information
Name of current school: * Required
Current grade: * Required
Your academic average at current school:
Applying for grade: * Required
Proposed year of entry: * Required
Applying for: * Required
- Boarder
- Day
- Undecided
Select all the tests taken:
- SSAT
- PSAT
- SAT
- Not yet taken
Enter SSAT overall test percentile:
Please enter a number from 0 to 100.
Enter PSAT overall test percentile:
Please enter a number less than or equal to 100.
Enter SAT overall test percentile:
Please enter a number less than or equal to 100.
Athletic information
Your favorite sport: * Required
Positions played in that sport: * Required
Jersey number:
Current team name:
Current coach's phone #:
Current coach's e-mail
List achievement or relevant statistics in that sport (please be as specific as possible):
Your 2nd favorite sport:
Positions played in the 2nd sport:
Jersey number in 2nd sport:
Current team name in 2nd sport:
Current Coach's phone # in 2nd sport:
Current Coach's e-mail in 2nd sport:
List achievement or relevant statistics in the 2nd sport (please be as specific as possible):
Your 3rd favorite sport:
Positions played in the 3rd sport:
Current team name in 3rd sport:
Jersey number in 3rd sport:
Current Coach's phone # in 3rd sport:
Current Coach's e-mail in 3rd sport:
List achievement or relevant statistics in the 3rd sport (please be as specific as possible):
Others
Have you scheduled a visit to Middlesex?
If yes, when is/was the visit? - must be mm/dd/yyyy format
MM slash DD slash YYYY
Have you received Middlesex Admissions Material?
Additional questions or comments:
Other schools that you are considering:

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Student contact

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