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Kentucky State University

Athletics

Recruiting Questionnaire

Personal Information

Date: (mm/dd/yyyy)
Name:
SSN: e.g. xxx-xx-xxxx
Date of Birth: (mm/dd/yyyy)
Called Name:
Phone: (e.g. xxx-xxx-xxxx)
E-mail:
Home Address:
City: State: Zip:
Parent Guardian Name: Mother: Father:
Parents Occupation: Mother: Father:
Number of children in family:
Age:
Top 3 College Choices:
1)
2)
3)

Academic Information

High School/Junior College:
Phone:
Address:
City: State: Zip:
Academic Interests:
Honors:
Extracurricular Activities:
ACT Composite Score:
SAT Scores V:
M:
Retaking? Date:
Graduation Year: GPA:
Class Rank: out of:

Athletic Information

Position(s) Played:(e.g. RB, LB, OL, CB) Number of Years Played:(e.g. 6 )
Jersey Number: Height: Weight: Pant Size:
Helmet Size: Shoe Size:
Time: 40 yd. Lift: Bench Lift: Squat Lift: Clean
Athletic Honors (indicate sport):
Other Sports Played:
Coach's Name: Phone:(e.g. xxx-xxx-xxxx)

FOOTBALL RECRUITING OFFICE (502)597-5889

  


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