South Carolina Wrestling Coaches Association

300 Columbia Ave.

Chapin, SC 29036

(803) 345-2246

APPLICATION FOR 2006 NORTH/SOUTH ALL-STAR WRESTLING MATCH

PLEASE PRINT OR TYPE INFORMATION:

First Name: _______________ MI:_____ Last Name:_________________________

Home Address:_________________________________________________________________

City:________________________ Zip Code:____________________

Home Phone: 8_____-_______-_________ Weight Class:_____________

School:__________________________________________ School Classification:_________

School Address:________________________________________________________________

City:________________________ Zip Code:____________________

School Phone:8_____-_______-_________

Coach:__________________________________ Home Phone:8_____-_______-_________

Record:

12^th__________ 11^th_________ 10^th__________ 9^th__________

Accomplishments:

Senior Year: ___________________________________________________________________

Junior Year:____________________________________________________________________

Soph Year:_____________________________________________________________________

Frosh Year:____________________________________________________________________

USE BACK TO COMPLETE IF NECESSARY

YOU MUST NOTIFY ME OF ANY WEIGHT CLASSIFICATION CHANGE

RETURN BY FEBRUARY 2, 2006 TO: COACH SCOTT HARMON

CHAPIN HIGH SCHOOL

300 COLUMBIA AVE.

CHAPIN, SC 29036

FAX # (803) 345-7111