Questionnaire

Contact Information
Name	E-mail	Phone
Address	City	State
Zip	Country
Personal Information
Date of Birth	Height	Weight
Parents/Guardian	Occupation
Academic Information
High School/Junior College	Address
City	State	Zip
Date of Graduation	GPA	SAT/ACT Score
Intended College Major
Athletic Participation
Coach's Name	Primary Position	Have you registered with Clearinghouse?
Varsity Sports Played (Indicate Number of Letters)	Key Statistics	Individual Awards/Recognitions
Team Awards/Recognitions	Other Information

Security Code