Pikeville College - Athletics - Football - Prospective Student-Athelete Questionnaire

 
 

Prospective Student-Athlete Questionnaire

Please complete all fields as accurately as possible. When finished, click “Submit” at the bottom to send your information. Click “Clear” to clear the questionnaire and start over.
     Personal information     
Name:

Nickname:

Mailing address:

City:

State:

ZIP:

Home telephone:

Date of birth:

Birth city:

Birth state:

Mother’s name:

Mother’s occupation:

Mother’s college:

Mother’s employer:

Mother’s work telephone:

Father’s name:

Father’s occupation:

Father’s college:

Father’s employer:

Father’s work telephone:

Guardian’s name:

Guardian’s employer:

Guardian’s work telephone:

With whom do you live?




E-mail address:

     Academic information     
High school:

High school mailing address:

High school city:

High school state:

High school ZIP:

High school telephone:

Graduation year:

High school coach’s name:

High school coach’s college:

High school coach’s home telephone:

High school coach’s work telephone:

GPA:

SAT-V:

SAT-M:

ACT:

Class rank:

College prep:


Academic counselor:

Academic honors:

Potential college major(s):
List all academic majors that you are considering.

Other colleges you are interested in:

Pikeville College personnel you know:
List anyone affiliated with Pikeville College (faculty, staff, alumni, athlete) that you know.

     Athletic information     
Offensive position(s) played:
(check all that apply)







Defensive position(s) played:
(check all that apply)







Preferred college position:
(list only one)

Specialties:

Height:

Weight:

Jersey number:

40-yard dash speed:

100-meter speed:

Other sports played:

Athletic honors:

Hobbies/Interests:

Most influential people in your life:

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