District 4 NEPSAC Application for Membership
PLEASE NOTE: The deadline to submit this application is September 15  of the academic year prior to the academic year a school is applying for membership into.
Email *
Type of membership your school is applying for: *
School Information
Name of School: *
School Address: *
School Phone *
School Fax *
Head of School *
Email *
Athletic Director *
Email *
Grades (Check all that apply) *
Required
Enrollment Information
Please complete information for both genders and all grade levels. Use a zero where non-applicable.
Total Enrollment - Girls *
Total Enrollment - Boys *
Total Enrollment - Boys PK-8 *
Total Enrollment - Girls PK-8 *
Total Enrollment - Boys 6-9 *
Total Enrollment - Girls 6-9 *
Total Enrollment - Boys 9-12 *
Total Enrollment - Girls 9-12 *
Total Enrollment - Boys PG *
Total Enrollment - Girls PG *
School Athletic Information
Boys varsity sports *
Offered at school
Intending to play
not applicable
cross country
football
soccer
water polo
basketball
ice hockey
skiing - alpine
skiing - nordic
squash
swimming and diving
baseball
golf
lacrosse
tennis
track and field
Girls varsity sports *
Offered at school
Intending to play
not applicable
cross country
field hockey
soccer
volleyball
basketball
ice hockey
skiing - alpine
skiing - nordic
squash
swimming and diving
golf
lacrosse
softball
tennis
track and field
water polo
Co-Ed Sports *
Offered at school
Intending to play
not applicable
wrestling
What are your reasons for joining NEPSAC? *
What is your school's mission? *
What is your athletic mission? *
What is the P.E./athletic requirement at your school? *
Please list the NEPSAC schools you currently play and in what sports. *
What percentage of your school population that is eligible for athletic participation actually   participates in interscholastic competition? *
What athletic facilities do you have? *
0
1
2
3
4
5
6
7
8
9
10
11
12
other
grass fields (field hockey, soccer, lacrosse)
turf fields (field hockey, soccer, lacrosse)
ice rinks
basketball courts
squash courts
volleyball courts
tennis courts
swimming pool (lanes)
diving well
baseballl field
softball field
track
wrestling (matches able to host)
What do you see as the future athletics at your school?  Initiatives?  Facilities?  New sports? *
Do you have a certified athletic trainer or other health professional on staff?  If no, do you employ an outside agency?   *
Additional Information to be Emailed
NEPSAC asks that upper schools be accredited by NEASC or the equivalent. By whom is your school accredited? Please email proof of accreditation to communications@nepsac.org.                                                                        

Please email a copy of your liability insurance to communications@nepsac.org.

Provide 3 letters of reference from a NEPSAC school

Provide schedule and results for the past two years in sports that you wishing to play within the NEPSAC  (include include both genders where applicable).
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