UW-L Men's Basketball Questionnaire

PERSONAL INFORMATION

First Name:  Last Name: 
Phone Number:  Email Address: 
Street Address:  Best Time to Call You: 
City:    State:        Zip:  Date of Birth:    (MM/DD/YY)
Father's Name:  Mother's Name: 
Father's Occupation:  Mother's Occupation: 
College Attended:  College Attended: 
   

ACADEMIC INFORMATION

High School:  School Phone: 
School Address: City/State:    Zip: 
Counselor's Name:  Counselor's Phone: 
GPA:  /4.0        GPA:  /5.0 Class Rank:  /
Year of Graduation:   
ACT  Composite:                 

Math:    English: 

Reading:    Science: 

SAT Total: 

Math: 

Verbal: 

Are you a transfer student? 

If yes, what college: 

Have you applied to UW-L?  

If yes, have you been accepted?

Anticipated Major (s):

1.     

2. 

Other Colleges You are Considering:

1.     

2.   

3.   

4.   

Would you like to receive any of the following information?

Application:      

Information on Major(s): 

Financial Aid information:      

Campus Visit Information: 

ATHLETIC INFORMATION

Height:    Position:    Uniform Number:   
Years on Varsity:     
Individual Stats (per game):  Points:   Rebounds:    Assists:   
Field Goal % (season):    Free Throw %:   3 pt. Field Goal %:   
Coach's Name:    Coach's Phone:   
   
Other Sports Played: Position: Varsity Letters: Head Coach:

Athletic Honors:    (Please include any school records you hold.)

Thank you for your time and interest.  Please mail a videotape, if available, to:  Ken Koebl, Head Men's Basketball Coach, UW-La Crosse, 1725 State St., 146 Mitchell Hall, La Crosse, WI 54601.  PHONE:  608-785-8819.  EMAIL:  Ken Koelbl.

UW-La Crosse Athletics