Name:

Date:

Address:

City:

State:

Zip:

Birthdate:

Church Pref:

E-Mail:

Phone:

Cell Phone:

School:

Coach:

Address:

City:

State:

Zip:

Coach's Phone Office:

Home:

Jersey Number:

# of Students in Graduating Class:

Graduation Year :

GPA:

Class Rank :

ACT:  (or)  SAT:

Team's Win/Lost Record:

Are Your Games Videotaped?:

Height:

Weight:

Postion You Play:

Postion You Want To Play in College:

-----------Per Game-------

Yr

Games
Played

(2) FG
M-A-%

(3) FG
M-A-%

FT
M-A-%

Scoring
Avg.

Reb.
Avg.

Asst.

Steals

Blocked Shots

List Honors or Awards You Have Received:

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