INDIVIDUAL CLASSIFICATION REQUEST FORM

_____________________________________________

(DATE)

NAME: __________________________________________________________________________________________

(LAST) (FIRST) (MIDDLE)

ADDRESS: _______________________________________________________________________________________

(STREET)

_______________________________________________________________________________________

(CITY) (ZIP CODE)

TELEPHONE: _____________________________________________________________________________________

(HOME) (BUSINESS)

E-MAIL ADDRESS: ________________________________________________________________________________

PARENT or

GUARDIAN: ______________________________________________________________________________________

DATE OF BIRTH: ____________________ AGE ON DEC 31: ____________________

LAST SIX TEAMS PLAYED FOR:

YEAR	TEAM	COACH	AGE	CLASS

LAST YEAR’S FINISH IN USSSA STATE _______________________________________________________________

TEAM YOU WISH TO PLAY FOR IN UPCOMING SEASON_________________________________________________

(NAME) (AGE) (CLASS)

Please submit all information that you think would help the Classification Committee in the decision process. Classification meetings are dealt with on a continual basis until June 1^st. The classification chairman may contact any club coach or high school coach that you have played for and ask for input. You will be contacted regarding the decision of the committee. If your declass request is denied, you have the right to appeal this decision in a face-to-face meeting with the committee.

I hereby submit the following reason(s) for my declassification request: (use additional sheets, if needed, and BE SPECIFIC)

(Player’s Signature) ____________________________________________________________________

SUBMIT TO: DEADLINE DATE:

COLORADO USSSA JUNE 1

PO BOX 993

BERTHOUD, CO 80513