Fillable DSCC Cheerleader Application I wish to be considered (Dyersburg State Community College)

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DSCC Cheerleader Application I wish to be considered (Dyersburg State Community College)

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DSCC Cheerleader Application
I wish to be considered for the position of Cheerleader and/or
Mascot. (Check at least 1)
Name: DSCC ID Number: D
Are you a current student or have you applied and been accepted for admission to DSCC? Yes / No
If no
, enrollment at DSCC is required before you may try-out for the DSCC Eagle Cheerleaders. The One Stop
located in the Student Center on the Dyersburg Campus can help you with the application process. Please
contact the Office of Student Services at 731/286-3240 after making application to the college to schedule a
try-out. Makeup try-outs will only be scheduled if positions on the team remain open.
PLEASE DO NOT SKIP ANY QUESTIONS -
Name and Address of High School or GED Testing Center:
Date of High School Graduation/GED Attainment:
If Applicable, name of the last college you attended:
Home Address: City/State/Zip
Email:
Home Phone: ( ) Cell Phone: ( ) (text messaging? Y/N)
EXPERIENCE
Prior cheer/gymnastics/dance experience is preferred but not required. If you have prior experience, give
where you trained/cheered and the dates:
Was it a positive experience?
HEALTH
List prior injuries:
Any physical therapy required? If yes, what type and where are/were you receiving this care?
List any medications you are currently taking on a regular basis.
List any allergies.
List Name/Phone number of your Physician:
Do you have health insurance? Yes / No
Proof of Health Insurance is required. DSCC students can take advantage of a student policy at a low rate. Contact Yuketa Hall
in the Office of Student Services for an application for this health insurance option at 731/286-3240.
TELL US MORE ABOUT YOU
List one reason you would like to join the DSCC Eagle Cheerleaders.
List any awards, honors and/or other achievements you have received in the past 5 years.
List clubs, organizations and community service you have been a part of in the past 5 years.
List 2 character references that are not family members and their contact information.
I am Male / Female. (circle one)
Shoe Size:
T-shirt size:
Short size:
I certify the above information is true. I understand that if this information is incorrect or incomplete I will be
excluded from the try-out process.
Signature Date
Statement of Vision Dyersburg State Community College will enhance the quality of life in West Tennessee by elevating the
region’s educational attainment. About DSCC Dyersburg State Community College is an open access, learning-centered
institution that serves seven counties in West Tennessee. Founded in 1969, DSCC’s vision is to enhance the quality of life in
West Tennessee by elevating the region’s educational attainment. The home campus of DSCC is in Dyersburg, and centers are
located in Covington, Trenton and Union City. Approximately 2,500 students are enrolled in Criminal Justice, Nursing and Allied
Health, Business and Technology, transfer, and developmental studies programs. DSCC is accredited by the Commission on
Colleges of the Southern Association of Colleges and Schools to award the associate degree. Learning is enhanced by a variety
of campus organizations, state of the art technology, service learning opportunities, and sports programs. The college also
serves the community by offering a variety of continuing education courses and online degree programs.
Dyersburg State Community College
Dyersburg – Covington – Trenton
1510 Lake Road, Dyersburg, TN 38024
731/286-3350
www.DSCC.edu
Enroll@DSCC.edu
AT-12-08
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DSCC Cheerleader Application I wish to be considered (Dyersburg State Community College)

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Completed 5 October 2020

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