First/Middle/Last Name:

Email:

Home Phone:

Permanent Address:

City:       State:      Zip:

SSN:       Birthdate:
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Father's Name:

Father/Occupation:

College Father Attended:


Mother's Name:

Mother/Occupation:

College Mother Attended:
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High School or Junior College:

High School or Junior College Address:

City:       State:      Zip:

Coach Name:

Coach Office Phone:

Coach Home Phone:      
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GPA(4.0 scale):

Graduation Date:
 ACT:      SAT:(math)      (verbal)

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Academic Interest: 1)
                                    2)
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Position:

Points:      Reb:      Assist:

F.G%:      F.T%:

Ht:      Wt:
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Other Sports:                                             
           

Academic/Athletic Honors:


Friends or Relatives who attended/are attending WSC: