Basketball Athletic Questionnaire

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Your Email:

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Full Name: *

Age: *

E-Mail Address:

Address

Street Address

Address continued

City

State

Zip

Phone #:

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Additional Info

Height:

Year of H.S. Graduation:

Parents or Guardian Name:

Parents' Occupation:

School:

School Street Address:

School City:

School State:

School Zip:

School Phone:

Coach:

Coach's Phone:

Rank In Class:

Number In Class:

G.P.A.:

ACT/SAT:

Academic Honors/Awards:

Possible College Major:

Athletic Honors/Awards:

Positions Played:

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