BASKETBALL QUESTIONNAIRE

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PERSONAL INFORMATION

Email address *

Full Name *

City *

Address *

Province/State *

Postal Code/Zip Code *

Country *

Phone Number *

Height *

SPORT SPECIFIC INFORMATION

Sport of Choice *

Please fill in the box for your sport(s). Include highlights such as points per game, provincial team experience, times in races, awards won, events you competed in, etc. *

Highlight Reel

Please provide a video highlight of your sport. You may copy and paste your YouTube link in the text box below.

HIGH SCHOOL INFORMATION

High School Name *

What grade are you currently in? *

Coach's Name *

Coach's Phone Number *

Coach's Email Address *

OTHER INFORMATION

What Lakeland program(s) are you interested in *

Why are you interested in attending Lakeland *

* required field