Chadron State College

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Women’s Basketball

Questionnaire

Contact and Personal Information
First Name:
Middle Initial:
Last Name:
Mailing Address:
City:
State:
Zip:
Phone Number:
Cell Phone:
Email:
Date of Birth:
Academic Information
High School or Junior College:
School Address:
School Phone Number:
Graduation Date:
GPA:
ACT Score:
SAT Score:
College Academic Interests:
Academic or Leadership Honors:
High School Coach:
Coach’s Phone Number:
Athletic Information
Primary Position:
Vertical Jump:
Height:
Weight:
Points per Game:
Rebounds per Game:
Field Goal %:
Free Throw %:
Three Point %:
Assists per Game:
Are Videos Available?:	Yes No
Orientation:	Right Handed Left Handed
Honors:
Ask the Coach:
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1000 Main Street, Chadron, NE 69337 • 1-800-CHADRON