Prospective Athlete Questionnaire
Prospective Athlete Questionnaire - Basketball
PERSONAL INFORMATION
Full Name:
Graduation Year:
Address:
City:
State:
Zip:
Cell Phone or
Other Phone:
Birth Date:
Father's Name:
Occupation:
Mother's Name:
Occupation:
Have any members of your family or friends attended Wartburg?
No
Yes
If so, who and when?
OPTIONAL ITEMS BELOW
Religious Preference:
Ethnic Origin:
ACADEMIC INFORMATION
High School:
HS Conference:
High School Address:
Guidance Counselor:
ACT or SAT Score:
Class Rank:
GPA:
Intended Major
in College:
What other colleges are you interested in?
ATHLETIC INFORMATION
High School Coach:
Coach's Phone:
Are you a transfer student?
No
Yes
If a transfer, what school?
Coach at previous college:
Coach's Phone:
SPORT-SPECIFIC INFORMATION
Your Gender:
Female
Male
Honors in Basketball:
Position:
Scoring Avg.:
Rebound Avg:
Assist Avg.:
Years Lettered:
Years as Starter:
Who were the two best players you faced?
Name:
School:
Pos.:
Year:
Name:
School:
Pos.:
Year:
Other high school sports:
Honors in those sports:
Contact E-mail
(REQUIRED)
:
Wartburg College
100 Wartburg Blvd.
Waverly, IA 50677
(800) 772-2085
