Prospective Student-Athlete Information Form

Name:

SS#Date:

Nickname:

Email Address:

Home Address:

City:State:Zip:

Height:Weight:Date of Birth:Home Phone:

School Name:School Phone:

School Address:City:State:Zip:

Mother's NameOccupation:

Father's Name: Occupation:

School Graduation Date:Planned College Major:

PSAT Scores: Verbal Math:

ACT Scores: Eng. Math:Reading:Sci.Reas.

SAT Scores: VerbalMath: Sci.Reas.Composite:

Class Rank:Approximate High School Average

Sport: **Select Sport** Baseball Men's Basketball Men's Cross Country Football Men's Track and Field Women's Basketball Women's Cross Country Women's Golf Men's Soccer Women's Soccer Women's Softball Women's Tennis Women's Track and Field Women's Volleyball Position:No.of Games:

Honors and Awards:

Coach:Coach's Phone:

Coach's Home Address:City:State:Zip:

Another Person Whom We Can Contact Regarding Your Future:

Person's Home Phone Number: