Men's Basketball

Men's Basketball Prospect Questionnaire

*If no answer is known, please put "N/A"


General Information
First Name:		Last Name:
Address:		Number:
City, ST Zip:		HT:
Home Phone:		WT:
Cell Phone:		Shoe Size:
E-mail Address:		SS#:
Birthday:		GPA:
Nickname:		SAT/ACT:
Grad Year:		Best Friend:
POS:		Girl Friend:

Family Information
Mother:		Father:
Mother's Job:		Father's Job:
Mother's Work Phone:		Father's Work Phone:
Mother's Email Address:		Father's Email Address:
Mother's Birthday:		Father's Birthday:

Brothers (Name/Age):		Sisters (Name/Age):




High School Information
High School:
Coach:		Counselor:
Coach's Home Phone:		Counselor's Phone:
Coach's Work Phone:		Registrar:
Coach's Email Address:		Registrar's Phone:
Athletic Period Time:	From: AM. PM.		To: AM. PM.

AUU Team Information
AUU Team:
Head Coach:		Asst/Mgr:
Head Coach's Address:		Asst/Mgr's Address:
Head Coach's City, Zip:		Asst/Mgr's City, Zip:
Head Coach's Home Phone:		Asst/Mgr's Home Phone:
Head Coach's Work Phone:		Asst/Mgr's Work Phone:
Head Coach's Cell Phone:		Asst/Mgr's Cell Phone:
Head Coach's Email Address:		Asst/Mgr's Email Address:

Transcript Release
I hereby authorize the release of my academic transcript to The University of Texas at Arlington.
Signature:		Date: