Personal Information
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| Name: |
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| Email: |
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| Address: |
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| City: |
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| State: |
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| Zip Code: |
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| Home Phone: |
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| Cell Phone: |
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| Height: |
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| Weight: |
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| Father's Name: |
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| Father's Occupation: |
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| Mother's Name: |
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| Mother's Occupation: |
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| Do you have game tape available? Yes No |
Academic Information
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| High School: |
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| Phone Number: |
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| Year of Graduation |
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| Current GPA: |
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| ACT Score: |
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| SAT Score: Verbal |
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| SAT Score: Total |
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| Counselor Name:: |
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| Desired College Major: |
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High School Athletic Information
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| Coach's Name: |
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| Coach's School Phone: |
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| Coach's Home Phone: |
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| Coach's Cell: |
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| Coach's Email: |
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| Primary Position: |
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| Secondary Position: |
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| Uniform #: |
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Club/Summer Team Information
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| Team Name: |
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| Coach's Name: |
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| Coach's Home Phone: |
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| Coach's Cell: |
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| Coach's Email: |
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| Primary Position: |
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| Secondary Position: |
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| Uniform #: |
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Miscellaneous Information
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Reason for interest in the Mt. Hood Community College Women's Basketball Program :
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Academic and athletic goals:
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Other hobbies, sports or activities:
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List the top three college of your choice: (In order of preference)
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Sports Specific - Basketball
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| Pts/Game |
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| Rebs/Game |
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| Asst/Game |
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| Stls/Game |
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| Blks/Game |
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Name three of the best players you have played against (name/height/school):
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