Questionnaire

Personal Information

* Denotes required fields
First Name: *
Last Name: * MI:

Mailing Address:
Street: *
City: * St: * Zip: *
Telephone:
Email: Age:
Date of Birth:
Height: Weight:

Scholastic Information

High School:
City:
Grad Date: *
Class Rank:
ACT/SAT Score:
HS GPA: College Transfer GPA:

Athletic Information

PPG: RPG: APG:
FG%: 3 Pt FG%: FT%:
Position: 2nd Position:
HS Coach:
Phone:
League Coach:
Phone:
Strengths:
Honors: Record:

Jared Stark, Athletic Director
York College
1125 East 8th Street
York, NE 68467
Phone: (402) 363-5635
Fax: (402) 363-5738

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