Athletics Questionnaire

* Denotes a required field.

Personal Information

Name:*

Address:*

City:*

State:*

Zip:*

Date of Birth:*

Religious Preference:

Home Phone:
--

Cell Phone:
--

Fax Number:
--

Email:*

Mother's Name:

Mother's Occupation:

Father's Name:

Father's Occupation:

Academic Information

High School or College:*

City:

State:

Level:

Graduation Year:*

GPA:

Class Rank:

SAT Score:

Math:

Critical Reading:

Writing:

Composite:

ACT Composite Score:

High School Counselor:

Phone Number:
--

Level of interest in UMHB:

Major of interest:

Other Colleges You are considering:

Athletic Information

Sport of Interest:

Position:

Level of interest in playing at UMHB:

Awards/Honors:

Coach's Information

High School Team:

Jersey Number:

Coach:

Phone:
--

Club/Summer Team:

Jersey Number:

Coach:

Phone:
--

Additional Comments: