Prospective Questionnaire: Mercer University Athletics

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MERCER WOMEN'S BASKETBALL PROSPECTIVE PLAYER QUESTIONNAIRE
Please fill out form as completely as possible

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Personal Information

*Name:
Cell Phone:		Home Phone:
E-Mail:		Date of Birth:
Address:
City:		State:		Zip:

Family Information

Father's Name:		Occupation:
Address, City, State, Zip (if different):
Father's Phone
Mother's Name:		Occupation:
Address, City, State, Zip (if different):
Mother's Phone:

Siblings/Relatives You Live With (include name, age & relationship of each):

Academic Information

High School/Prep School Name:
HS Address:
HS City:		HS State:		HS Zip:
HS Phone Number:		Graduation Date:
HS Counselor's Name:
Core Grade Point Average:
SAT Overall Score:		SAT Math Score:
SAT Written Score:		SAT Reading Score:
ACT Composite Score:
TOEFL (if an international student):

List any other high schools you attended (with address and grade point average there):

Are you registered with the NCAA Clearinghouse? Yes No

What are your top 3 choices as a possible academic major?
1. 2. 3.

Transfer Students Only

List All Other Schools Attended (in order, most recent first)

School Location GPA & Credits Years Attended

Women's Basketball Information

Height:

Weight:

Position:

High School Information

HS
Coach:

HS Coach's
Phone:

HS Coach's
E-Mail:

PPG:		RPG:		ASST:		BLKS:
FG%		3FG%		FT%

High School Honors and Award:

Junior College Information

JC
Coach:

JC Coach's
Phone:

JC Coach's
E-Mail:

PPG:		RPG:		ASST:		BLKS:
FG%		3FG%		FT%

JC Honors and Awards:

AAU Team Information

AAU Team Name:

AAU
Coach:

AAU Coach's
Phone:

AAU Coach's
E-Mail:

PPG:		RPG:		ASST:		BLKS:
FG%		3FG%		FT%

AAU Team Honors and Awards:

Personal Information

Key Influences/
Relationships:

Other Schools You
are Considering:

Favorites

Sports Teams:		Athletes:		Other Sports/Hobbies:
Foods:		Music:

Any Additional Notes/Comments:

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