PERSONAL INFORMATION

Full Name:

Social Security #: example: 123-45-6789

Email Address:

Home Phone # example: (555) 555-1234

Cell Phone # example: (555) 555-1234

FAX # example: (555) 555-1234

Mailing Address:

City: State:

ZIP: Country:

Birthdate: JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Age: 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29+

FAMILY INFORMATION

Mother's Name: Mother's Occupation:

Father's Name: Father's Occupation:

HIGH SCHOOL INFORMATION

Name of High School: Year of HS Graduation:

High School City & State:

High School Coach: Coach Phone #: example: (555) 555-1234

High School G.P.A.: SAT or ACT Score (if applicable):

COLLEGE INFORMATION

Have you ever attended a college or university? YES NO If NO, skip to "Basketball Info" section

Current College or University (if applicable):

College City & State:

College Coach: Coach Phone #: example: (555) 555-1234

BASKETBALL INFORMATION

Position: PG SG Guard SF Wing PF C Post Height: under 5' - 6" 5' - 6" 5' - 7" 5' - 8" 5' - 9" 5' - 10" 5' - 11" 6' - 0" 6' - 1" 6' - 2" 6' - 3" 6' - 4" 6' - 5" 6' - 6" 6' - 7" 6' - 8" 6' - 9" 6' - 10" 6' - 11" 7' or taller Weight:

How many years did you play basketball in HS? 1 2 3 4 Years on varsity? 1 2 3 4

Statistics, IF known, for Current Season (if at least 5 games) OR from most recent completed season:

Points per game: Rebounds per game: Assists per game:

Use this box to list other relevant basketball statistics, honors & achievements:

JUST A FEW MORE QUESTIONS...

Have you already submitted a FAFSA application? Yes No

Are you eligible to receive a pell grant? Yes No Not Sure

Do you have your own car? Yes No

Did you find our website using a search engine? Yes No

If YES, which one? If NO, how did you hear about our website?

To complete this form indicating your interest in Cabrillo men's basketball and submit it to the coaching staff, please click on the "Submit" button: