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Dutchmen Football Questionnaire
GENERAL INFORMATION:
First Name:
Middle Initial:
Last Name:
Telephone:
Address:
City:
State:
Zip:
Date of Birth (mm/dd/yyyy):
Email Address:
Cell Phone:
Mother/Guardian:
Occupation:
Business Phone:
Father/Guardian:
Occupation:
Business Phone:
Brothers:
Sisters:
ACADEMIC INFORMATION:
Name of High School:
Guidance Counselor:
S.A.T. Scores:
CR:
M:
W:
ACT Score:
Cum. GPA:
Class Rank:
out of
Please list your academic interest(s) or major field(s) of study:
Date you will graduate from high school:
Month:
Year:
ATHLETIC INFORMATION:
Height:
Weight:
Jersey Number:
40 Speed:
Max. Bench:
Your Position:
Offense:
Defense:
Preferred Position:
Athletic honors attained in football:
Specialties (Punt, Kick Off, Long Snap, etc.):
Coach's Name:
E-mail:
Home Phone:
Office Phone:
What high school sports did you play?
What other varsity sports do you want to play in college?
Friends/relatives attending or graduates of Lebanon Valley: