PLEASE PRINT THIS FORM, FILL OUT AND MAIL TO ADDRESS BELOW.

Sports         Basketball     Baseball     Football     Track & Field

Youth Prep Stars    Your Sport______________________________________

STUDENT ATHLETE INFORMATION SHEET

Todayís Date: __________Birth Date: ____________SS #:_____________________________

Full Name: _________________________________Phone(       )_________________________

Nickname/Preferred First Name: ________________Religion (optional)___________________

Address:_____________________________________________________________________                  

                                                     Street                 City                             ST                      ZIP

Fatherís Name: __________________________Occupation:___________________________

Motherís Name: _________________________Occupation:____________________________

Business Phones: Father:(       )_________________ Mother(         )_______________________

College Parent (s) Attended: __________________# of Brothers______ # of Sisters_________

University Student/Friends Alumni you know:________________________________________

Year in School: _________H. S. Graduation Date: ___________Place of Birth:_____________

ATHLETIC PARTICIPATION

Height: _____Weight:_____ Uniform Playing Number/School Colors:____________________

H. S. Playing Position (s)/Events: _________________________L of R Handed:_____________

H.S. Club Statistics (Please list best times/ marks/finishes/scores:_______________________

___________________________________________________________________________

 

Second Sport You Play: ________________Does Your H. S./Club Video Events?_____________

High School Coach: ________________________Home Phone(      )______________________

School Phone(       )_________________________

Club Team: _________________Coach: _______________Home Phone(      )______________

Honors youíve won:____________________________________________________________

___________________________________________________________________________

ACADEMICS

High School: __________________________High School Principal:____________________

High School Counselor: _________________________Phone(      )______________________

High School Address:_________________________________________________________

                                                                             Street          City           ST                Zip

 

GPA: _____Class Rank: __________SAT Verbal/Math:________ __ACT Score: ___________

Favorite Class:_______________________________________________________________

Academic Study Interests/Possible College Major:___________________________________

__________________________________________________________________________

Academic Honors:____________________________________________________________

Colleges you are considering (in order): 1.__________________ __2.___________________

3. _____________________________4.___________________ __5.__________________

 

 

NCAA ELIGIBILITY ACADEMIC INFORMATION

(List all Grades for Classes Taken)

 

9th Grade                         10th Grade                     11th Grade List any additional college prep

                                                                                                            classes you have taken with grade:

 

Eng_______________ Eng __________________Eng______________________________

Alg. 1_____________  Geometry _____________Alg. 2_____________________________

Science____________ Biology _______________Science___________________________

For. Lang.__________ For. Lang. _____________For. Lang.__________________________

Hist.______________ Hist. _________________Civics_____________________________

Other_____________ Other ______________ __Other____________________________

 

 

Please sign your name if it is OK for University/College to access your high school transcript/academic record for admission purposes:  IF UNDER 18 YEARS, PARENT MUST SIGN.

 

 

 

Signature:______________________________________________________

 

 

 

 

 

 

ATHLETIC INFORMATION QUESTIONS

 

  1. What camps, tournaments or events will you participate in this summer? (Please list when and where)

1._____________________________________________________________________________________________

 

2._____________________________________________________________________________________________

 

3._____________________________________________________________________________________________

 

4._____________________________________________________________________________________________

 

5._____________________________________________________________________________________________

 

6._____________________________________________________________________________________________

2. Do you have any specific guidelines your parent, you or your coach want the universities to follow in recruiting you?

 

____________________________________________________________________________________________________

 

3.Is it OK for us to make direct phone contact with you?

 

_______________________________________________________________

 

4. Why are you considering _______________________(University/College)?

 

________________________________________________________________

 

5. Have you visited the University/College before? If yes, When?

 

________________________________________________________________

 

6. If you have not taken the SAT/ACT test, when will you take it?

 

________________________________________________________________

 

7. What are your sport/career ambitions?

 

_______________________________________________________________

 

Relevant References: Name: ________________Title: _________Phone(      )___________

 

 

Name: _________________Title: _____________Phone(        )______________________

 

 

MAIL THIS FORM TO:      Youth Prep Stars

 

                                              Player Profile Dept.

 

                                              P. O. Box 16994

 

                                             Atlanta, Georgia 30321

 

 

Payment Type enclosed:  ______Money Order/CK $ 350.00/Year

       

                                          ______Credit Card   $ 350.00/Year

 

 

Circle Card Type:       VISA       M/C        Am/Ex        Discover 

 

Name on Card_________________________________________________

 

Card Number__________________________________________________

 

Expiration Date______________  

Signature __________________________________Date_______________