		Prospective Student/ Athlete Questionnaire

Personal Information
Name:	(Last) , (First) (Middle)
Gender:	Male Female	Date of birth:	(mm/dd/yyyy)
Email:		Home phone:
		Cell phone:
Home address:	(Street) (City) (State) (ZIP)
Height:		Weight:	(Men only)
Father:		Occupation:
Email:		Work phone:

Mother:		Occupation:
Email:		Work phone:

Siblings at home:		Siblings in college:
List any relatives or friends associated with Azusa Pacific:
Academic Information
High school:		Graduation date:
Address:	(Street) (City) (State) (ZIP)
Grade-point average:		Anticipated major:
Previous colleges (junior college and four year):
Address:	(Street) (City) (State) (ZIP)
Previous colleges (junior college and four year):
Address:	(Street) (City) (State) (ZIP)
SAT:	(Verbal) (Math)	ACT:
Class rank:	/
Academic awards:
Basketball-Specific Questions
Position:

Minutes per game:		Points per game:
Rebounds per game:		Assists per game:
Steals per game:		Blocks per game:

Club team:		Club coach:
Have you applied for financial aid?
Other schools you are considering: