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Men's Basketball Questionnaire

Personal Data
Last Name:
First Name:
Address:
City:
State:
Zip Code:
Home Phone:
E-Mail:
Social Security:
Birth date:


Family Data
Father's Name:
Address:
City:
State:
Zip Code:
Father's Occupation:
Father's Employer:
Alma Mater:
Mother's Name:
Address:
City:
State:
Zip Code:
Mother's Occupation:
Mother's Employer:
Alma Mater:
Sister's Names:
Brother's Names:


Academic Information
Year in High School:
High School Attended:
Address:
City:
State:
Zip Code:
Phone Number:
Counselor:
School Size:
Graduation Date:
GPA:
SAT Score:
ACT Score:
Class Rank:
College Choice #1:
College Choice #2:
College Choice #3:
College Choice #4:


Athletic Information
Height:
Weight:
Any Game Tape Available:
Vertical Jump Height:
Position Played:
_
_
Athletic Injuries:
Other Sports Played:
_
_
Honors in Basketball:
Honors in Other Sports:
Coach's Name:
Coach's Phone Number:
Have you registered with the NCAA Clearinghouse?