Apply for Our Elite Academy - Red Devils Basketball

Thank you for taking the time to apply for our elite basketball academy. There is a $100, non-refundable processing fee for each application. After you fill out the application, you will be prompted to pay with a credit card or PayPal account. If you do not have the ability to pay with a credit card or PayPal account, please call us at (386) 846-8394 and we will accept a check or cash.

Your Name:*
Your Email:*
Home Phone:
Cell Phone:
Parent / Guardian Name:
Address:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
High School:
High School Graduation Year:
Interested Course of Study:
Cumulative G.P.A.:
SAT Score:
Date SAT Taken:
ACT Score:
Date ACT Taken:
Program Package:
- Housing
- Non-Housing
Height:
Weight:
Position:
Shirt Size:
Pant Size:
Shoe Size:
Date of Last Physical Exam:
Medical Conditions:
Allergies:
Medical Insurance Carrier:
Dental Insurance Carrier:
Video Availalbe?
- Yes
- No
High School Coach:
High School Coach Phone:
Club School Coach:
Club School Coach Phone:
Awards/Honors (Conference, State?):
Parent / Guardian Electronic Signature:*
Product Name
Complete Payment:*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Total
$0.00
Email
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