Personal Information

Required fields are marked with an asterisk.*

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First Name*
Last Name*
Name You Prefer to be Called
Address
City
State
ZIP
Height Weight Vertical Jump
Home Phone
Wireless Phone
Email*
Name of Father:
Name of Mother:
High School*: School Phone:
High School Address
City
State
ZIP
Basketball Coach:
Your Planned College Major:
You were recommended to the University by:
Capital Students or Alumni you know:

Athletic Participation

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Honors or awards in basketball (include letters earned):
Videotape available?
Other Sports Played:

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Year Graduating:
Class Rank/No. In Class:
Present GPA:
Have you taken your SAT/ACT?
If yes, score? If not, when will you take them?
Guidance Counselor:
Counselor's Phone:
(Please send basketball schedule when it is available to: Dixie Jeffers, Women's Basketball Coach, Capital University, Columbus, OH 43209-2394)