Athletics at Fanshawe College
Intercollegiate programs
Athlete Prospect form
Athlete Bio
Sport:
Name:
Hometown Address:
City:
Prov: Postal Code:
Email:
Home Phone:
Local Phone:
Cell Phone:
Name of Parents/Guardians:
Positions:
Relevant Information Only:
Weight: kg lbs
Height: cm inches
Vertical: cm inches
Hand Dominance:
Foot Dominance:
Golf Handicap:
Date of Birth:
v
Academic
Student #:
Start Date:
v
OCAS Application #:
End Date:
v
Registered Program:
Alternative Program Choice:
Are you Applying to Residence?
Are you in a Registered Apprenticeship Program?
Are you applying or registered in a collaborative program?
Do you have a valid passport?
Have you played for a University or College?
High School
High School:
City / Town:
Prov: Country:
Postal Code:
Awards/Accomplishments:
Club Affiliation
Club Name:
Years:
Coach:
Phone:
Email:
Elite Playing Experience:
Privacy Compliance
NOTICE: The personal information on this form is collected under the authority of the Ministry of Colleges and Universities R.Sc. 1980 C272. The personal information will be used to record student participation in varsity and extramural sports, determine eligibility and academic performance, maintain OCAA and CCAA records, notify emergency contact, international travel (US Customs) plan athletic programs, determine administration for media promotion and marketing. Questions about the collection should be directed to the Manager of Athletics.
 
CONSENT: Pursuant to section 39 of the Freedom of Information and Protection of Privacy Act, I have read the above statement and I, the undersigned, herby authorize the disclosure of necessary information to the above mentioned parties.
Signature
Date
Return To...
Athletic staff contact or coach:
Coaches
Varsity Head Coach Contacts:
Rob Pereira
Men's Soccer
robpereira@rocketmail.com 

Patrick Johnston
Men's Volleyball
pjohnston@fanshawec.ca

Tony Marcotullio
Men's Basketball
tmarcotullio@fanshawec.ca
Mike Marcaccio
Women's Soccer
michaelmarcaccio@gmail.com
Sean Pellow
Women's Volleyball
spellow@fanshawec.ca
Bill Carriere
Women's Basketball
bcarriere@fanshawec.ca
Matt Plachta
Badminton
plachtam@hotmail.com
Ashely Vandervecht
Cross Country
ashleyvandervecht@gmail.com

Colin Robertson
Golf
c_robertson@fanshawec.ca

Brian Harvey
Men's Baseball
bharvey@fanshawec.ca
Barry Westman
Curling
bwestman@fanshawec.ca
Catherine Arthur
Women's Softball
c_arthur@fanshawec.ca 

Eligibility Information
For Eligibility Information Please View:
OCAA website (http://ocaa.com/info/eligibility/)

CCAA website (http://www.ccaa.ca/new/document.php#policies)

or contact

Rob Thorpe 519-452-4430 Ext. 4104 rthorpe@fanshawec.ca
Joanne Verbeek 519-452-4430 Ext. 4937 jverbeek@fanshawec.ca