Please Print
Name ________________________________________________________________________________
Address _______________________________________________________ Apt. # _________________
City___________________________________ State ____________ Zip _________________________
Telephone (_____) _________________________ Cell (______) _______________________________
Date of Birth _______________________ E-mail: __________________________@________________
Height _________________ Weight _______________ Position ________________________________
High School _________________________________________ Year Graduated ___________________
If not a HS graduate, provide status (expected graduation date or GED status):
_____________________________________________________________________________________
Latest SAT / ACT Score: ______________________ Grade Point Avg: _________________________
Have you ever attended a college? If so, please provide names and years attended:
_____________________________________________________________________________________
_____________________________________________________________________________________
Last school team you played for: _______________________________ Year ______________________
School Coach Name __________________________________ Phone (_____) _____________________
Scoring Average __________ Rebound Average __________ Assists Average _________
AAU Team _________________________________ Coach ___________________________________
Phone (______) ______________________________
Significant honors or awards received:
____________________________________________________________________________________
____________________________________________________________________________________
List the College(s) you are interested in:
_____________________________________________________________________________________
____________________________________________________________________________________
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