Women's Basketball Player Profile

If you are interested in playing for the Coffeyville Community College women's basketball team, please fill the form below as completely as possible. The information you provide will be sent directly to the coaching staff at CCC.

Recruiting Questionnaire

Name: Date of Birth:

Height: Weight:

Home Phone: () Cell Phone: ()

Home Address: City:

State: Zip: Email Address:

Father's Name: Mother's Name:

Father's Occupation: Mother's Occupation:

Number of brothers/sisters: How many still live at home:

High School: School Phone: ()

School Address: City: State: Zip:

Name of High School Basketball Coach:

Current Position: Potential College Position:

Point Avg. (Jr. Year): Point Avg. (Sr. Year):

Rebound Avg. (Jr. Year): Rebound Avg. (Sr. Year):

Assist Avg. (Jr. Year): Assist Avg. (Sr. Year):

Steal Avg. (Jr. Year): Steal Avg. (Sr. Year):

Other Significant Accomplishments:

High School GPA: Test Scores: ACT SAT

If you have not taken these tests, when will you do so?

High School Graduation Date:

List any other players that you would recommend for college recruitment:

Name	Class	Height	High School

Yes, this information is correct. (Required) Please check this circle once you have double-checked the information provided for accuracy.

(Please click the submission button only once. It may take a few moments to process your information. You will be directed to a "success" page when your information has been sent to the coaching staff at Coffeyville Community College).