SHEPHERD UNIVERSITY
WOMEN’S BASKETBALL
** Please cut and paste this information into your email
and send it back to mford@shepherd.edu **
Name ________________________
Address ______________________ City _________________ State, Zip ____________
Date of Birth ______________ Email ____________________________________
Home Phone Number (___) ____ - _____ Cell Phone Number (___) ____ - _____
Parents or Guardians ____________________________________________________
Parents’ Occupation: Mother ________________ Father _________________
Parents Business Phone: Mother ________________ Father _________________
Brothers’ Names and Ages _______________________________________________
Sisters’ Names and Ages _________________________________________________
ATHLETIC INFORMATION
Height ________ Weight ________ Position(s) _______________________________
Right / Left Handed _______ Uniform Number: Home ______ Away ______
High School ____________________________ HS Head Coach __________________
Coach’s Home Address ___________________________________________________
Phone: Home (___) ____ - _____ Work (___) ____ - _____ Cell (___) ____ - _____
Statistics FRESHMAN SOPHOMORE JUNIOR SENIOR
Scoring Avg. ______ ______ ______ ______
Reb. Avg ______ ______ ______ ______
Assist Avg. ______ ______ ______ ______
Steals Avg. ______ ______ ______ ______
Vertical Jump _________________ Mile Time ______________
Are game tapes available? _____________________________________________
ACADEMIC
High School Graduation Date ___/ ___/ _______ GPA ________ Class Rank _______
School Address __________________________________________________________
School Phone (____) ____ - ______ School Website ____________________________
Principal _____________________ Guidance Counselor _________________________
Desired Major _________________ Academic Honors ___________________________
How many years in each of the following courses will you have completed upon graduation?
English _________ Algebra _________ Geometry __________ Other Math ___________
Social Sciences __________ Foreign Language __________ Physical Science _________
Have you registered with the NCAA Clearing House? ____________________________
Have you taken your college board exam? __________ If not, when _________________
SAT Score: Verbal _______ Math ________ ACT Score: _____________
GENERAL
Shepherd Alumni/Students You Know ___________________________________________
Hobbies/Special Interests
________________________________________________
List Five Schools You Would Consider Attending: 1. ________________________
2. _____________________________ 3. _______________________________
4. _____________________________ 5. _______________________________
Will Distance from Home Be A Factor In Your Decision? Yes _______ No _______
Indicate Your Interest In Shepherd University : Strong ____ Moderate ____ Not Sure ____
Would you like to be contacted by our staff? Yes _____ No _____