UNIVERSITY OF PITTSBURGH AT GREENSBURG
RECRUIT QUESTIONNAIRE

Personal Data

1.) Name (Last name, first name, middle initial): 

2.) Date of birth: ) Social Security #: 

3.) Prefer to be called : 

4.) Permanent Address & Phone:
Street, P.O. Box, etc.: 

City: State: Zip: 

Area Code and Phone #: 

4.) E-mail Address: 

Academic Information

6.) High School and Year of Graduation:
7.) School Phone Number: 
8.)Guidance Counselor: Class rank: out of 
9.) SAT Score: Math Verbal Act Score: 
10.)GPA on a scale of 
11.) Desired field of study in college: 
12.) Other schools interested in: 

Family

13.) Father's Name:
14.) Father's occupation: 
15.) Father's College: 

16.) Mother's Name:
17. Mother's occupation: 
18.) Mother's College: 

19.) I live with (Check one)MotherFatherBoth parents
Other (specify) 

20.) Siblings at home and ages:

21.) Siblings in college and which schools:

Athletic Information

22.) Indicate which sport you are interested in: (Multiple items may be selected by holding down the Ctrl key)

23.) Height: Weight: 
24.) Position: Years experience: 
25.) Coach's name: Coach's phone number:

26.) Please list vital statistics and awards or honors you have received:

27.) Film/Tape available YesNo

28.) Summer Camps and Leagues involved in:

29.) Local Newspaper: 

30.) Secondary Sport:

31.) Any additional information that you think our coaches should know: