Basketball Questionnaire
Illinois Valley Community College
Attention: Men's Basketball
815 N. Orlando Smith Avenue
Oglesby, IL 61348
Or e-mail to Tommy_Canale@ivcc.edu.
Please print or write legibly.
Name: _______________ _______________ _______________
(Last)
(First)
(Middle)
Personal Information
Home Address _______________ City _______________ State _______________ Zip _______________
Date of Birth _______________ E-mail Address _______________ Cell Phone _______________
Home Phone _______________ Social Security Number _______________ High School _______________
Year of Graduation _______________ Coach's Name _______________ School Phone _______________ Home Phone _______________
Parent's or Guardian _______________ Occupations _______________
Other Children in your family and age(s) _____________________________________________
Friend's or Alumni at IVCC that you know? _____________________________________________
Other Schools that you are considering? _____________________________________________
Athletic Information
Position_____ Height____ Weight___ Pts./Game____ Reb./Game)))) Asst./Game____ Ft%____
FG%____ 3Pt.%____ Position you would like to play in college? _____ Jersey #_____
Shoe Size _____ Which is your dominant hand, Left or Right?_____
Name of the most influential person in your life_______________
List of Honors and Awards______________________________
Name of the best player you played against?______________________________ His High School_______________
List of your strengths as a player_______________ Weakness_______________
List your future goals______________________________
Academic Information
Rank in Class_______________ GPA_______________ ACT Score_______________ SAT Score_______________
Are you registered with the NCAA Clearinghouse?_______________ Are you a NCAA Qualifier?_______________
What would you like to major in?_______________ Other college(s) attend_______________
Counselor's Name_______________ Office Phone_______________
Principal's Name_______________
Date Completed