Prospective Basketball Player's Questionnaire

Fill out the following information and it will be sent directly to Coach Lance.

You can then fill out an online application or browse the Missouri Valley College website.

Personal
Name:
Age:
Birthdate:
Home Address:
City:
State:
Zip:
Phone Number:
Cell Phone:
Height:
Weight:
Email Address: *required
Father's Name:
Father's Phone Number:
Mother's Name:
Mother's Phone Number:

Academic
High School:
GPA:
Date of Graduation:
Guidance Counselor:
Counselor's Phone Number:
Class Rank	out of
Academic Test Taken:	ACT SAT	Score
Academic Area of Interest:

*For Transfer Students Only*
School:
Phone Number:
School Address:
Will you graduate?	Yes No
Date of Graduation:
Hours Completed:
GPA:

General Athletic Information
Other high school sports you paticipated in:
Team Accomplishments:
Individual Honors, Awards, etc.:

Athletics

Please add any useful information for your particular sport. Position, 40 time, etc.