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  1. Name:  Year of Graduation: 
  2. Date of Birth:   
  3. Email Address: 
  4. Date of Birth: 
  5. Address: 
  6. City:  State:  Zip: 
  7. Home Phone: 
  8. Father's Name:  Occupation:  College: 
  9. Mother's Name:  Occupation:  College: 
  10. Siblings in College:  Siblings at Home (age): 
  11. High School:  High School Phone: 
  12. Coach:   
  13. Coach's Home Phone: 
  14. Guidance Counselor: 
  15. Height:  Weight:  Position: 
  16. Rank in Class:  PSAT Score: 
  17. SAT(M):  SAT(V):  High School GPA: 
  18. Financial Aid Form Filed:  If so, when: 
  19. Have you visited Behrend:  When: 
  20. Relatives in Erie Area:
  21. Desired College Major:
  22. Other Schools Interested In:
  23. Basketball Statistics:
    Points/gm:  Rebounds/gm:  Assists/gm:  Steals/gm: 
  24. Film/tape available: 
  25. Other Sports Played:
  26. Summer Camps and Leagues:
  27. Local Newspaper(s):
  28. Additional Information: