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Prospective Players Questionnaire

Personal Information
Name:
Email:
Address:
City:
State:
Zip Code:
Home Phone:
Cell Phone:
Height:
Weight:
Father's Name:
Father's Occupation:
Mother's Name:
Mother's Occupation:
Do you have game tape available? Yes No

Academic Information
High School:
Phone Number:
Year of Graduation
Current GPA:
ACT Score:
SAT Score: Verbal
SAT Score: Total
Counselor Name::
Desired College Major:

High School Athletic Information
Coach's Name:
Coach's School Phone:
Coach's Home Phone:
Coach's Cell:
Coach's Email:  
Primary Position:
Secondary Position:  
Uniform #:

Club/Summer Team Information
Team Name:
Coach's Name:
Coach's Home Phone:
Coach's Cell:
Coach's Email:
Primary Position:
Secondary Position:
Uniform #:
   
Miscellaneous Information
Reason for interest in the Mt. Hood Community College Men's Basketball Program :
 

 
Academic and athletic goals:
 
Other hobbies, sports or activities:
 
List the top three college of your choice: (In order of preference)
 


Sports Specific - Basketball
Pts/Game
Rebs/Game
Asst/Game
Stls/Game
Blks/Game
Name three of the best players you have played against (name/height/school):
 


PLEASE EITHER PRINT AND SEND THE COMPLETED QUESTIONAIRE TO:
Geoff Gibor
Mt. Hood Community College
Department of Athletics - Men's Basketball
26000 SE Stark St
Gresham Oregon 97030

OR

CLICK THE SUBMIT BUTTON and it will be sent directly to Coach Gibor's Email

   
© 2013 Mt. Hood Community College | 26000 SE Stark St. | Gresham, OR 97030 | 503-491-6422
 Last Modified: 3/31/2010 8:49:10 AM