QFS Holidays
Penn Men's Basketball Recruit Questionnaire
NOTE: This form is not an official University of Pennsylvania application. This form will be used by the coaching staff to help determine prospective student-athletes. WARNING: NCAA rules prohibit coaches from contacting freshmen and sophomores in high school. Only junior, senior and preparatory students are permitted to use this form.

Required Fields in Bold

 
PERSONAL INFORMATION

Last Name:
 
First Name, Middle Initial:
 
Gender:
 
Address:
 
City/State/Zip:
 
 
Home Phone Number:
 
Cell Phone Number:
 
Email:
 
Date of Birth:
 
Father's Name:
 
Father's Occupation:
 
Father's Alma Mater
 
Father's Phone:
 
Mother's Name:
 
Mother's Occupation:
 
Mother's Alma Mater
 
Mother's Phone:
 
Brothers/Sisters (Names/Ages):
 
 
ACADEMIC INFORMATION

High School:
 
Address:
 
Guidance Counselor:
 
Phone:
 
Grade Point Average:
 
Graduation Year:
 
Class Rank:
 
Class Size:
 
SAT I (Verbal) Best Score:
 
SAT I (Math) Best Score:
 
SAT I (Writing) Best Score:
 
ACT Best Score:
 
Honors or AP Classes (please indicate grade received):
 
SAT II Subject & Score:
 
Course of Study Desired:
 
Other schools that interest you:
 
 
BASKETBALL INFORMATION

Height
 
Weight:
 
Position:
 
Points per game:
 
Rebounds per game:
 
Assists per game:
 
Basketball Honors:
 
High School Coach:
 
 
Work Number:

Home Number:
 
AAU Team:
 
AAU Coach:
 
Work Phone:
 
Home Phone:
 
advertisement
Geico
The Inquirer
PNC Bank
Milk
Independence Blue Cross
Chili's
Coke Zero
Home Team IBC
Dunkin Donuts
Coke Zero
Bank of America
Geico