Men's Basketball Recruit Questionnaire

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Personal Information

Email address *

First name *

Last name *

Address 1 *

City *

State *

ZIP Code *

Phone Number

Date of Birth (DD/MM/YY) *

Parent(s) Information

Parent (1) First / Last Name:

Parent (1) Phone Number

Parent (2) First / Last Name

Parent (2) Phone Number

High School Information

High School Name *

City *

State *

Zip Code *

Graduation Date *

GPA (Grade Point Average) *

What is your academic interest?

Have you taken the SAT/ACT?

Yes No

Have you attended another college? *

Yes No

If attended another college, where *

College GPA

Have you registered with the NCAA Eligibility Center?

Yes No

If so, what is the NCAA Eligibility Center #

Have you completed an application for admission to Florida State College at Jacksonville?

Yes No

Athletic Information

Height *

Weight *

Position *

PPG (points per game)

RPG (rebounds per game)

APG (assists per game)

Athletic Achievements

Academic Achievements

High School Coach Name: *

Coach Phone Number *

AAU /Club/Travel Team Name

AAU/Club/Travel Coach

AAU/Club/Travel Coach Phone Number

Link to game Film/Highlights (if applicable)

Additional Film/Highlight Link

* required field