WBU Queens Basketball Questionnaire

Wayland Flying Queens Basketball

WOMEN'S BASKETBALL PROSPECITVE STUDENT ATHLETE QUESTIONNAIRE

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* Field Required
*Last Name:	*First Name:

*SS#	*Address:

*City:	*State:	*Zip:

*Home Phone: ( ) -	Cell Phone: ( ) -

Best Time to Call:	Grad Year:	Birth date: (mm/dd/yy)

*Email Address:

Mother's Name:	Occupation:

Mother's Work Number: ( ) -

Father's Name:	Occupation:

Father's Work Number: ( ) -

Height - Ft: . Inches:	Weight:	Age:

Living with (check one)

ACADEMICS

High School:		Phone: ( ) -

JUCO:		Phone: ( ) -

School Address:		Counselor:

Coach's name:		Coach's Home Phone: ( ) -

Coach's Office Phone: ( ) -		Graduation Date: (mmddyy)


JUCO Hours Passed: GPA: /4.0 Class Rank: Number of Students in Class:


SAT: ACT: Date Taken:

Anticipated major:

ATHLETICS

Jersey Number: Position:		Average Points: Average Rebounds:


Average Assists: Field Goal %: Free Throw %: 3 point %


Athletics Honors:


Summer league/AAU/BCI team names:

Summer Coach:		Summer Coach's Phone: ( ) -

TRANSCRIPTS

*I hereby give Wayland Baptist University my consent to receive a copy of my official transcripts and test scores: Yes No