PLEASE PRINT THIS FORM, FILL OUT AND MAIL TO ADDRESS BELOW.
Sports Basketball Baseball Football Track & Field
Youth Prep Stars
Your Sport______________________________________STUDENT ATHLETE INFORMATION SHEET
Today’s Date: __________Birth Date: ____________SS #:_____________________________
Full Name: _________________________________Phone( )_________________________
Nickname/Preferred First Name: ________________Religion (optional)___________________
Address:_____________________________________________________________________
Street City ST ZIP
Father’s Name: __________________________Occupation:___________________________
Mother’s Name: _________________________Occupation:____________________________
Business Phones: Father:( )_________________ Mother( )_______________________
College Parent (s) Attended: __________________# of Brothers______ # of Sisters_________
University Student/Friends Alumni you know:________________________________________
Year in School: _________H. S. Graduation Date: ___________Place of Birth:_____________
ATHLETIC PARTICIPATION
Height: _____Weight:_____ Uniform Playing Number/School Colors:____________________
H. S. Playing Position (s)/Events: _________________________L of R Handed:_____________
H.S. Club Statistics (Please list best times/ marks/finishes/scores:_______________________
___________________________________________________________________________
Second Sport You Play: ________________Does Your H. S./Club Video Events?_____________
High School Coach: ________________________Home Phone( )______________________
School Phone( )_________________________
Club Team: _________________Coach: _______________Home Phone( )______________
Honors you’ve won:____________________________________________________________
___________________________________________________________________________
ACADEMICS
High School: __________________________High School Principal:____________________
High School Counselor: _________________________Phone( )______________________
High School Address:_________________________________________________________
Street City ST Zip
GPA: _____Class Rank: __________SAT Verbal/Math:________ __ACT Score: ___________
Favorite Class:_______________________________________________________________
Academic Study Interests/Possible College Major:___________________________________
__________________________________________________________________________
Academic Honors:____________________________________________________________
Colleges you are considering (in order): 1.__________________ __2.___________________
3. _____________________________4.___________________ __5.__________________
NCAA ELIGIBILITY ACADEMIC INFORMATION
(List all Grades for Classes Taken)
9th Grade 10th Grade 11th Grade List any additional college prep
classes you have taken with grade:
Eng_______________ Eng __________________Eng______________________________
Alg. 1_____________ Geometry _____________Alg. 2_____________________________
Science____________ Biology _______________Science___________________________
For. Lang.__________ For. Lang. _____________For. Lang.__________________________
Hist.______________ Hist. _________________Civics_____________________________
Other_____________ Other ______________ __Other____________________________
Please sign your name if it is OK for University/College to access your high school transcript/academic record for admission purposes: IF UNDER 18 YEARS, PARENT MUST SIGN.
Signature:______________________________________________________
ATHLETIC INFORMATION QUESTIONS
What camps, tournaments or events will you participate in this summer? (Please list when and where)
1._____________________________________________________________________________________________
2._____________________________________________________________________________________________
3._____________________________________________________________________________________________
4._____________________________________________________________________________________________
5._____________________________________________________________________________________________
6._____________________________________________________________________________________________
2. Do you have any specific guidelines your parent, you or your coach want the universities to follow in recruiting you?
____________________________________________________________________________________________________
3.Is it OK for us to make direct phone contact with you?
_______________________________________________________________
4. Why are you considering _______________________(University/College)?
________________________________________________________________
5. Have you visited the University/College before? If yes, When?
________________________________________________________________
6. If you have not taken the SAT/ACT test, when will you take it?
________________________________________________________________
7. What are your sport/career ambitions?
_______________________________________________________________
Relevant References: Name: ________________Title: _________Phone( )___________
Name: _________________Title: _____________Phone( )______________________
MAIL THIS FORM TO: Youth Prep Stars
Player Profile Dept.
P. O. Box 16994
Atlanta, Georgia 30321
Payment Type enclosed: ______Money Order/CK $ 350.00/Year
______Credit Card $ 350.00/Year
Circle Card Type: VISA M/C Am/Ex Discover
Name on Card_________________________________________________
Card Number__________________________________________________
Expiration Date______________
Signature __________________________________Date_______________