MILLERSVILLE UNIVERSITY
MEN'S BASKETBALL
RECRUITMENT FORM

PERSONAL INFORMATION

Your name

DOB (MM/DD/YY)

Email Address

Home Phone Number

Street Address

City

State

Zip Code

Father's Name

Father's Occupation

Mother's Name

Mother's Occupation

ACADEMIC INFORMATION

High School		Year of Grad.	GPA
SAT Date	Total Score	Verbal	Math
High School Academic Honors
Jr. College, Community College or University Previously Attended
Enrolled from to		# Cr. Earned	GPA
Intended major at MU
Have you applied to the NCAA Clearinghouse? Yes No
Have you applied to Millersville University? Yes No

ATHLETIC INFORMATION

High School Coach

High School Coach's Phone Number

Position

No. Yrs as Starter

Jersey #

Height

Weight

Points Per Game

Rebounds Per Game

Assists Per Game

AAU Coach

AAU Coach's Phone Number

AAU Team

Jersey #

Video Available?

Yes No

List any Honors or Awards you have received (captain, all-conference, etc.)

OTHER INFORMATION

Other Varsity Sports Played

List any other information you would like to share with the coaching staff below