Canarias Basketball Academy

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CBA PROGRAMS APPLICATION
Applicant: Please complete entire application.
Return application along with a 100€ (non-refundable) application processing fee and a passport size photograph by email to register@cbacademy.org

APPLICANT INFORMATION

Today ´s Date:

Name:

Family Name:

Home Address:

City/State/Province:

Country:

Zip/Postal Code:

Home Phone: (include country, city and area codes)

Cell Phone: (include country, city and area codes)

Fax:

E-Mail:

Gender:

Male
Female

Date of Birth (DD/MM/YY):

Age:

Referred by:

I am Applying for the period (Month/Year):

Boarding Student
Non Boarding Student

In the Basketball Program called:

Post Graduate Program
Post Graduate Program U´18
Full Term High School
Short Term
Team Camps
Summer-Christmas Camp
Proffesional Workouts
Adult Training

Parent/Guardian Information

Relationship (Mother, Father, stepfather, stepmoher, other):

First Name:

Middle Name:

Last Name:

Use same address as Applicant:

Address (Line 1):

Address (Line 2):

City:

State/Province:

Country:

Zip/Postal Code:

Home Phone: (include country, city and area codes)

Cell Phone: (include country, city and area codes)

Fax:

E-Mail:

Employer:

Occupation:

Business Address:

City:

State/Province:

Country:

Postal Code:

Business Phone: (include country, city and area codes)

Business Fax:

Parent/Guardian Information

Relationship (Mother, Father, stepfather, stepmoher, other):

First Name:

Middle Name:

Last Name:

Use same address as Applicant:

Address (Line 1):

Address (Line 2):

City:

State/Province:

Country:

Zip/Postal Code:

Home Phone: (include country, city and area codes)

Cell Phone: (include country, city and area codes)

Fax:

E-Mail:

Employer:

Occupation:

Business Address:

City:

State/Province:

Country:

Postal Code:

Business Phone: (include country, city and area codes)

Business Fax:

EDUCATION

Present School:

School Address:

City:

State/Province:

Zip/Postal Code:

Country:

School Telephone: (include country, city and area codes)

Teacher/Counselor:

Independent
Private/Parochial
Public

Dates of Attendance:

Current Grade Level:

Current Grade Point Average:

School Awards/Honors:

OBJECTIVES

List two short- term goals and two long-term goals in the following spaces.
Please be specific.

Short-Term1:

Short-Term2:

Long-Term1:

Long-Term2:

Why are you applying to the Full Term program, and what do you hope to gain from your experience at the CBA ACADEMY?

Describe how you first became involved in your sport:

Describe your typical daily schedule. Include school, sport and fitness training, and time spent on homework:

Describe your best performance in Basketball. Include ranking, Stats or team record if applicable:

List other sports do you enjoy playing/hobbies/special interests:

Name a person who has influenced you in a positive way and tell why:

Briefly describe yourself as a person. Include the qualities you like best and those you can improve on:

If applying to our boarding program, is this your first experience living away from home? If no, please explain:

What languages do you speak?

Are you fluent in these languages?

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