Student-Athlete Questionaire-Men's Basketball

Student-Athlete Questionaire
Today's Date

MonthDayYear
Date of Birth

MonthDayYear
Full Name

First NameLast Name
Height
Weight
Player Position

Other
Home Address: Street
City
State
Zip
Home Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
E-mail
Parent/Guardian

First NameLast Name
High School Information
Parent/Guardian Contact Phone

Area CodePhone Number
Parent/Guardian Contact E-mail
High School
Street Address
City
State
Zip
Did you graduate ?
Yes/No
Graduation Date

MonthDayYear
GPA
SAT/ACT
Did you earn a GED ?
Yes/No
GED: Date Earned

MonthDayYear
Have enrolled in a college previously ?
High School Head Coach

First NameLast Name
Head Coach Number

Area CodePhone Number
College Transfer Information
College/University
Date Attended-Start Date

MonthDayYear
Date Attended-End Date

MonthDayYear
College/University
Date Attended-Start Date

MonthDayYear
Date Attended-End Date

MonthDayYear
College/University
Date Attended-Start Date

MonthDayYear
Date Attended-End Date

MonthDayYear
College/University
Date Attended-Start Date

MonthDayYear
Date Attended-End Date

MonthDayYear
Have you graduated from a College or University
Did you participate in Athletics ?
Which Sport(s)

Other
Awards
Welcome to Jaguar Nation !
By submitting my form, I understand that information falsified or omitted can make me ineligible for ALL future college competition in compliance with the National Junior College Athletic Association Eligibity Rules.
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Student-Athlete Questionaire