University of the Sciences
Prospective Student Athlete Questionnaire

Personal Information
 
First Name: Middle Init: Last Name:
   
Address:
City: State: Zip Code:
           
E-mail:      
           
Date of Birth:
Month:		 Day Year
           
Height: Weight:    
           
Telephone
(Area Code):		 Best time
to Call:		    
           
Mother's
Name:		 Father's
Name:		    


High School/Athletic Information
 
High School:
School Address:
           
Guidance Counselor: Counselor's cell#:
Counselor's e-mail:        
           

I plan to participate in the following intercollegiate sports in college:


Men's:

Baseball
Basketball
Cross Country
Tennis

Women's:

Basketball
Cross Country
Rifle
Softball
Tennis
Volleyball

  
Mixed Teams:

Golf
Rifle

Have you registered for the NCAA Clearinghouse? Yes No
Will your parents file a Financial Aid Form? Yes No


Please provide information for each sport in which you plan to participate:

#1

  
SPORT: 
Head Coach:
Coach's Phone #:
Coach's E-mail:
Position(s)/Event(s):
Years Varsity:
Athletic Honors/Stats:
Summer/Club team:
Do you have a video available? Yes No

#2

  
SPORT: 
Head Coach:
Coach's Phone #:
Coach's E-mail:
Position(s)/Event(s):
Years Varsity:
Athletic Honors/Stats:
Summer/Club team:
Do you have a video available? Yes No

#3

  
SPORT: 
Head Coach:
Coach's Phone #:
Coach's E-mail:
Position(s)/Event(s):
Years Varsity:
Athletic Honors/Stats:
Summer/Club team:
Do you have a video available? Yes No

Academic Information
 
Desired Major:
        
SAT Scores: Critical Reading:   Math:   Writing:
ACT Scores:   Grade Point
Average:		      
Class Rank:   out of:      
Expected Date of Graduation: