Men's Basketball Recruiting Questionnaire

Email address *

Personal Information

First Name

Last Name

Street Address

City

State

Zip

Home Phone

Cell Phone

Height

Weight

Date of Birth

Married

Yes No

Father's Name

Occupation

Mother's Name

Occupation

How many people live in the household?

How many will be in college next year?

Approximate household income?

under $35,000 $35,000-$50,000 $50,000-$65,000 over $65,000

Would you like to visit the campus?

Yes No

Scholastic Information

High School

School Phone

Graduation Year

GPA

Class Rank

ACT

SAT

College Course of Interest

Previous College Info

College Name

GPA

Hours Passed

How many years of eligibility do you have left?

Men's Basketball Information

Name of High School Coach

Coach's Phone Number

Name of AAU Coach

AAU Coach's Phone Number

Positions Played

Scoring Average (this year and last)

Field Goal Percentage

Other current Statistics

Athletic and/or Academic Honors/Awards:

Are game/match tapes available?

Yes No

* required field