Athletic Questionnaire

References

First Name:
Last Name:
Street Address:
City, State, and Zip:
Phone Number:
Email Address:
High School:
Grad Year:
HS Enrollment Size:
HS GPA:
Gender:	Male Female
Height:
Weight:
Would you like for the coach to contact you?	No Yes, by Phone Yes, by E-mail
Sport(s):	Basketball Soccer Volleyball Cross Country
Primary Position that you played:
Position that you prefer to play:
Years played on varsity team:
Were you a starter on the team?	No Yes
If Yes, how many years?
If No, how much time did you play?
Please list any High School or AAU Coach:
Name:
Phone Number:
E-mail Address:
Please list two other references:
Name:
Phone Number:
E-mail Address:
Name:
Phone Number:
E-mail Address:

Is there any other information that you think would be helpful for us to have (i.e. honors or awards received, or any comments or questions?
If you have any game tape available, please send us a labeled tape to us at: Barclay College Athletic Department 607 N Kingman Haviland KS, 67059 (Game tapes cannot be returned)