Prospective Student-Athlete

Women's Basketball Questionnaire

PERSONAL BACKGROUND

First Name: Last Name:
Name you go by: Email Address:
Phone Number: Number of Children in Family:
Street Address: City:
State: Zip:
Date of Birth (MM/DD/Year): Social Security #:    
Father's Name: Mother's Name:
Father's Occupation: Mother's Occupation:
Does either of your parents work at Washington University? Yes No
College Attended: College Attended:
Living with Mother Father Both Other          Ethnic Origin (optional):

ACADEMIC BACKGROUND (Please list Washington U. as one of the schools to receive your test scores.)

High School High School City:
High School State: High School Zip:
Coach's Name and Email Address: Home Phone:
Counselor's Name and Email Address: School Phone:
GPA: /4.0 Class Rank: / SAT-CR: SAT-M: SAT-W:
ACT    Composite:   Math:    English:   Reading:    Science: Writing:
List Senior Year Classes (indicate AP or Honors): Date of Graduation:
List the average grade you will receive (upon graduation) in these courses: Geometry: Trigonometry: Calculus: Physics:  Chemistry:
Academic Honors:
Academic Interests:

1)

2) 3)
Other Colleges You are Interested In:

1)

2) 3)
Friends or Relatives who Attended Washington :


ATHLETIC BACKGROUND

Height:   Weight:   Position:   Uniform No (light):     Uniform No (dark):
Years on varsity:     Other Varsity Sports Played:
High School Record: Freshman:    Sophomore:   Junior:    Years Started:
Individual Statistics (per game): Points:    Rebounds:   Assists:
Field goal percentage (season):    Free Throw percentage:   3-PT field goal percentage:
Basketball Strengths:

Athletic Honors:

Thank you for your time and interest. Please mail a videotape, if available, to: Nancy Fahey, Head Basketball Coach, Washington Univ., Box 1067, One Brookings Drive, St. Louis, MO 63130-4899. PHONE: (314) 935-4702  EMAIL: nancyf@athletics.wustl.edu