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  • Questionnaire for Prospective Volleyball Players

    Personal Information
    Full Name:
    Home Address:
    City:
    State:
    Zip Code:
    Home Phone:
    Fax:
    Email Address
    Birth Date:mm/dd/yyyy
    Year of HS Graduation:

    Parent / Guardian Information
    Father's Name:
    Father's Occupation:
    Mother's Name:
    Mother's Occupation:

    High School Information
    High School:
    High School Address:  
    HS Graduation Date:
    HS Grade Point Average:
    Class Ranking (rank/class size):   out of    

    Standardized Test Scores  
    PSAT: Verbal: Math:
    SAT: Verbal: Math:
    ACT: Composite:  
    Academic Honors:    

    Athletic Information
    Position:
    Dominant Hand:
    High School  
    HS Coach's Name:
    HS Coach's Home Phone:
    HS Coach's Work Phone:
    HS Coach's email address:
    HS Jersey # :
    Club  
    Club Name
    Club Coach's Name:
    Club Coach's Home Phone:
    Club Coach's Work Phone:
    Club Coach's email address:
    Club Jersey # :
    Height:
    Weight:
    Standing Reach:
    Vertical Jump without Approach
    (Block jump):
    Vertical Jump with Approach
    (2 foot takeoff):
    Vertical Jump with Approach
    (1 foot takeoff):
    Bench Press (1 Max Rep):
    Squat (1 Max Rep):
    Have you suffered any serious injuries? If so, please list:  
    Have you ever had any surgeries?
    If so, please list:    		  

    Mt. Hood Community College
    Potential Area of Study:
    List your top 3 college choices: 
    How interested are you in attending Mt. Hood Community College?  

    If you have a video tape available (including demonstration of skills as well as a complete unedited game) and if you have a high school and club volleyball schedule, please send it to the address below.
     

    Contact Information

     

    Head Coach:  Kirsten "Kirt" Day
    Office Phone: 503-491-7453
    Fax: 503-491-7397
    Email Address: Kirsten.Day@mhcc.edu
    Web Site: www.mhcc.edu

    PLEASE EITHER PRINT AND SEND THE COMPLETED QUESTIONAIRE TO:
    Mt. Hood CC Volleyball
    26000 SE Stark St
    Gresham Oregon 97030

    OR

    CLICK THE SUBMIT BUTTON and it will be sent directly to Coach Kirsten Day's email