40.30.3.3.4 - ELIGIBILITY CERTIFICATE University: Queen's University Sport: Nordic Ski - M Year: 2009-2010

Student #

Firstname Scott Alexandre Christopher Andrew Taylor Ian Paul Matthew Colin

Lastname Brandon Dumond Hey Joyce Lougheed Scriver Scriver Siddall Sutherland

Pos

Hgt 6-4 5-6 6-2 6-0 6-2 5-11 5-11 6-5 6-1

Wgt

Elig. Yr. 3 1 2 6 1 4 2 1 4

DOB 20/08/1985 07/08/1989 28/09/1990 31/10/1981 04/04/1985 12/08/1988 16/10/1990 05/01/1991 24/01/1986

Course Mechanical and Materials Engineering Kinesiology Mining Engineering Engineering Physics Medicine Mathematics and Engineering Geological Sciences Life Sciences Electrical Engineering

If presently Expected ineligible, date of please eligibility for indicate Transfer or Study Yr. Home Town Prov. University Last Team with an "X" Professional 7 Uxbridge Ont. Queen's 3 Ottawa Ont. Queen's 2 Sudbury Ont. Queen's 8 Peterborough Ont. Queen's 7 Stouffville Ont. Queen's 4 Ottawa Ont. Queen's 2 Ottawa Ont. Queen's 1 Orillia Ont. Queen's 4 Victoria B.C. Queen's

Signature of Director of Athletics or Designate

________________________________________________

Date

_______________

Signature of Head Coach

________________________________________________

Date

_______________

Signature of Registrar or Designate

________________________________________________

Date

_______________

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