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Prospective Student Questionnaire

Contact Information

Full Name:

Street Address:

Address continued:

City:

State:

Zip:

Country:

Home Phone: ( )

Cell Phone: ( )

E-Mail Address:

Parents/Guardians:

Academic Information

High School:

Graduation Year:

City:

Grade Point Average:

Rank in Class: /

ACT Score:

SAT Score:

College Academic Major(s):

Athletic Information

Years of Varsity Experience:

Height:

Weight:

Scoring Average:

Rebounding Average:

Assist Average:

Positions Played:

Basketball Honors:

List any other collegiate sports in which you would like to compete:

Athletic Honors in the above sports:

Do you know any Luther College students and/or alumni?

Yes No

Please list names: