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USTA PLAYER BACKGROUND HISTORY
NAME:______USTA Member #: ______League Team # ______
(Provide maiden name or other spellings if you have been known by any other name or spelling)
ADDRESS: ______HOME PHONE : ( ______) ______
______WORK PHONE: ( ______) ______
CITY/STATE/ZIP: ______E-MAIL: ______
GENDER: Male Female Date/Birth ______FAX: ______
GENERAL INFORMATION
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Please read the NTRP playing characteristics & the Elite Player Guidelines for National and Section Ranked/ College/Pro/ Teaching Professionals before self-rating: They are available as a link on first page of TennisLink league registration
SELF-RATE: 2.5 3.0 3.5 4.0 4.5 5.0 5.5 6.0
How long have you played tennis? ______total years
Do you play in other competitive leagues/club programs?
YES ______What level: _____ NO _____
Name of League(s): ______
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LIST SPORT AFFILIATIONS (example – USPTA)
Affiliation How Long
______
______
Have you ever worked as a college coach or tennis teaching professional? Most Recent dates
_____ College Coach ______
_____Teaching Professional ______
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TENNIS EXPERIENCE ITF/ National/ Highest
JUNIOR HISTORY WHERE YEAR(s) Section/State Position or Ranking
High School Tennis Team ______
ITF/National/Section Junior Rankings______
COLLEGE HISTORY
College Tennis Team ______
(circle Div.) I II III NAIA and Junior College
PROFESSIONAL HISTORY
(i.e. Foreign/Satellite/Davis Cup/Fed Cup)______
Special Recognitions/ Rankings / Achievements during ______
High School or College career: Provide year and title ______
Other Organized Competitive Sports (Example: Volleyball, Lacrosse, Baseball, sport you lettered in)
Indicate High School or College ______
______
USTA LEAGUE INFORMATION
List most recent year you played USA League Tennis and History: Year: ______Never played ____
Year(s) Section/District Local or highest Championship reached (Dist./Sectional/National) NTRP Level
______
______
USTA TOURNAMENT INFORMATION
List most recent year you played in NTRP, Age or Open tournaments? ______
Divisions you have played: NTRP levels: ______Age (specify) /Open ______
Ranking # Held Year NTRP, Age or Open Singles or Doubles Section or National
______
______
OTHER CONSIDERATIONS (use back if necessary)
Do you have any special physical or medical conditions that would affect your level of play? YES ____ NO ____
Describe: ( be brief and specific – Date of injury, diagnosis, treatment, prognosis and name attending physician) ______
Are you currently being treated for an injury that would affect your tennis? YES _____ NO _____
Provide specifics: ______
List any other information that may impact your tennis history or rating level: ______
______
I state the information presented is correct. If it is found that I have falsified or omitted any pertinent information, it may result in disqualification from USTA League Tennis play.
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Office Use:Date Received / Processed by:
NTRP Decision: / Approved at: / Denied – New Level
Date Notified
Method(circle) / e-mail / Phone / Mail / Other
Submitted by: Player ___ Captain/Admin ___
______
Player’s Signature
______
Print Name
Date: ______
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