Questionnaire

First Name
e.g. Roland
Last Name
e.g. Smithson
Address
e.g. 23 Mongul Park Drive,
City
e.g. Los Angeles
State
e.g. California
Zip
e.g. 58632
Home Number
e.g. 222-555-8799
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Cell Number
e.g. 222-555-8799
Your Email
e.g. johnsmith@smith.com
Home School Name
e.g. Blake High School
Grade
e.g. 11th Grade
GPA
e.g. 3.4
Graduation Year
e.g. 2012
Coach's Name
Coach's Phone
e.g. 222-555-8799
Sport Played
e.g. Football, Basketball
Position
e.g. Linebacker, Point-guard
Athletic Stats
e.g. .400
Height
e.g. 6 feet 10 inches
Weight
e.g. 230 pounds
Sex
e.g. Male, Female
Highlight Reel?
e.g. Yes or No
Parent/Guardian Name
Parent/Guardian Phone Number
e.g. 222-555-8799
Facebook/Twitter
e.g. https://www.facebook.com/studentathletes.intouch