LAST NAME:_____________________________________________

FIRST NAME:______________________  MIDDLE________________

STREET:_________________________________________________

CITY:__________________________ STATE:____ ZIP:____________

HOME PHONE:________________ E-MAIL ADDRESS:_____________

DATE OF BIRTH:___________________________________________

SOC.SEC.#:______________________________________________

HEIGHT:_________________WEIGHT:_________________________

HIGH SCHOOL POSITION___________________________________

PT. AVG.:________REB. AVG.:______ASSIST AVG.:______________

STEAL AVG.:_______BLOCK AVG.:___________________________

ARE FILMS AVAILABLE?___________________________________
IF SO, PLEASE SEND ONE OR TWO, ALONG WITH SCHEDULE.

NAME OF HIGH SCHOOL:____________________________________

GRADUATION DATE:_______________________________________

SCHOOL ADDRESS:_______________________________________

SCHOOL PHONE:_________________________________________

HEAD COACH:____________________ HOME PHONE:____________

OFFICE PHONE:___________________________________________

HIGH SCHOOL COUNSELOR:________________________________

OFFICE PHONE:__________________________________________

GRADE POINT AVG.(4.0 SCALE):______________________________

CLASS RANK:_________/_________ACT:_______SAT:___________

INTENDED COURSE OF STUDY:_______________________________

MOTHER'S NAME:_________________________________________

FATHER'S NAME:_________________________________________

MOTHER'S OCCUPATION:___________________________________

FATHER'S OCCUPATION:____________________________________

BROTHERS AND SISTERS:___________________________________

PARENT'S ALMA MATER:_____________________________________

DO YOU HAVE ACCESS TO A FAX NUMBER?:____________________

FAX #:__________________________________________________

OTHER SPORTS?:_________________________________________

TELL US YOUR OTHER INTERESTS.:___________________________