Name:   _____________________________________ (first, middle initial, last)

DOB:   ____ / _____ / _________

Email Address:   ___________________________________________

Home Phone:   ______________________ (please include area code)

Address:   ________________________________State:____ Zip:________

School:   Name:_________________________Phone:__________________

               Coach:_________________________Grad. Date HS:____________

               H.S. GPA:______     Class Rank:______     SAT/ACT:___________

               Counselor:__________________________Office Phone:_________________

Academic Interest:________________________________________________________

Intended Major:   _______________________________________________

Primary Position:   __________________ Other Position(s): _____________________

Height:____ Weight:____ 40/60 Time:________   Film Available: ( Y )____  ( N )____

Point Average: _____ Rebound Avg:______ Assist Avg:______ Steal Avg:______

Jersey Number:   Light:_____Dark:______

Other Varsity Sports:   ___________________________________________________       

Father:   Name:_________________________   Occupation:______________________

                Alma Mater:______________________________________

Mother:   Name:________________________    Occupation:______________________

                 Alma Mater:______________________________________

Brothers and Sisters:   ____________________________________________________

________________________________________________________________________

Injuries:   _______________________________________________________________

Operations:   ____________________________________________________________

Relatives at Miles:   ______________________________________________________

Recreational Activities/Hobbies:   __________________________________________

_______________________________________________________________________

Other:   Academic Honors:_________________________________________________

________________________________________________________________________

               Athletic Honors:___________________________________________________

________________________________________________________________________