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Prospective Student-Athlete Questionnaire

PERSONAL INFORMATION

NCAA Eligibility Center ID#:

Student-athlete Name (first/middle/last/nickname): 

Date of Birth (mo/da/yr):

Address:

City/State/Zip:

Home Phone and Cell Phone: 

Student-athlete E-mail:

Personal Interests:

Volunteer Service:

Parent’s or Guardian’s Name(s):

Parent’s or Guardian’s College(s) Attended:

Parent’s or Guardian’s E-mail:

HIGH SCHOOL INFORMATION

High School: Class of:

Address:

City/State/Zip:

Current Year (Fr/SoJrSr):GPA: Class Rank:

SAT Scores (Reading/Writing/Math): ACT Score:

Academic Achievements and Awards:



HS Counselor’s Name:

HS Counselor’s Phone #:

HS Coach’s Name:

HS Coach’s Phone # / Cell #:

Other Coach’s Name:

Other Coach’s Phone # / Cell #:

ATHLETIC INFORMATION

Jersey Number: Jersey Color:Years on Varsity:

HGT: WGT:Dominant Hand/Foot:

Primary Sport / Position:

Other Sport(s) / Position(s):

Speed - 40yds: 55m:100m:Other:

Strength - Bench:    Squat: Power Clean: Other:

Agility - Vertical Jump: Broad Jump:

Athletic Achievements and Awards / Personal Records:


PRIORITIES FOR CHOOSING A COLLEGE

Region (Mid-Atlantic/Northeast/South/Midwest/Southwest/West/All) Select One:

Academic Major(s):

Size (Under 5,000 / Under 10,000 / Over 10,000 / Over 20,000):

Division (I, II, III, NAIA, JC) Select All That Apply:

COLLEGES UNDER CONSIDERATION

Top Choices:

Others:

FINANCIAL AID INFORMATION

Have you applied for financial aid?: If Yes, When?:

VIDEO AND PHOTOS

Do you have quality game or workout footage?:If yes, please upload it.

Do you have a headshot?:           Do you have an action Shot?:If yes, please upload them.

REFERENCES

Academics (Provide Comment / Reference Name / Relationship to Student-athlete):




Athletics (Provide Comment / Reference Name / Relationship to Student-athlete):




Character (Provide Comment / Reference Name / Relationship to Student-athlete):
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