Men's Basketball Questionnaire

If you are interested in competing in men's basketball at Indiana State University, please complete the following form and submit it to a member of the ISU coaching staff. This form will be used by the coaching staff to help determine prospective student athletes. NCAA rules prohibit coaches from contacting freshman and sophomores in high school. This form is NOT an official university application.

GENERAL INFORMATION:

NAME: 
E-MAIL ADDRESS:
HOME PHONE NUMBER:
HOME MAILING ADDRESS:
CITY: 
STATE: 
ZIP: 
BIRTHDATE:
AGE:
SOCIAL SECURITY NUMBER:
FATHER'S NAME (OR LEGAL GUARDIAN):
FATHER'S OCCUPATION:
FATHER'S COLLEGE/UNIVERSITY ATTENDED:
MOTHER'S NAME (OR LEGAL GUARDIAN):
MOTHER'S OCCUPATION:
MOTHER'S COLLEGE/UNIVERSITY ATTENDED:
BROTHER'S/SISTER'S NAMES AND AGES:
LIST ANYONE YOU KNOW FROM INDIANA STATE UNIVERSITY:

ATHLETIC INFORMATION:

HEIGHT: 
WEIGHT: 
PRIMARY POSITION: 
JERSEY NUMBER: 
BASKETBALL HONORS: 
OTHER SPORTS YOU PLAYED: 
COACH'S NAME: 
COACH'S OFFICE PHONE: 
COACH'S HOME PHONE: 
FROM WHICH COLLEGE OR UNIVERSITY DID YOUR COACH GRADUATE: 

SCHOLASTIC INFORMATION
HIGH SCHOOL ATTENDED / JUNIOR COLLEGE: 
GRADUATION DATE: 
ADDRESS: 
CITY: 
STATE: 
ZIP: 
ACADEMIC INTEREST:    SECOND CHOICE: 
NAME OF ACADEMIC COUNSELOR: 
COUNSELOR'S OFFICE PHONE: 
CLASS RANK #:  OUT OF #: 
GPA: 
ACT COMPOSITE TEST SCORE: 
PRE-ACT COMPOSITE TEST SCORE: 
SAT COMPOSITE TEST SCORE: 
PRE-SAT COMPOSITE TEST SCORE: 


Please include any comments or additional information, which will help to evaluate your skills both academically and athletically as a prospective student-athlete at Indiana State University.
COMMENTS: 
 
 


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