Questionnaire

CHADRON STATE COLLEGE
Armstrong Gymnasium, Chadron, NE 69337
Volleyball Office 308-432-6346
Amy Spruiell - Head Coach, aspruiell@csc.edu

Personal Information
E-mail Address	First Name	Last Name
Home Phone	Cell Phone
Mailing Address
City	State	Zip
Birth Date
Parents/Guardian(s)	Father's Occupation	Mother's Occupation
Siblings Names and Ages
Academic Information
High School or Junior College	School Address	Phone Number
Principal	Guidance Counselor
Graduation Date	GPA	ACT/SAT
College Academic Interest
Academic or Leadership Honors	Top five colleges or universities you are interested in	College and university teams that have shown interest in you
Why are you interested in CSC?
Volleyball Information
Are videos available?	Have you registered with Clearinghouse?
High School Coach	Coach's Phone Number
Primary Position	Height	Weight
High School Record	High School Class/Division (1A, 2A, 3A, etc.)
Block Touch	Approach Touch	Right/Left Handed
Club Teams	Club Jersey Number
Club Coach	Club Coach's Phone Number
Club Schedule	Volleyball Honors

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