Online Questionnaire

About You
Last Name:   First Name: Middle Initial:

Street:  
City: 
State: 
 Zip Code:  
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Home Phone:   E-mail Address: 
Date of Birth:   Social Security Number:  
Mother’s Name:   Father’s Name: 
Mother’s Occupation:   Work phone: 
Father’s Occupation:   Phone: 
Brothers and Sisters:  Parents Alma Mater: 

About Basketball
Name of High School:   Year of Graduation:  
School Address:   City:  
State:  Zip Code: 
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Height: Weight:  High School Position (s): 
Point Average: Rebound Average:   Assist Average: Steal Average: 
Head Coach: Home Phone: Office Phone: 
Honors and Recognition (high school):
Are Films Available? Yes No Other Sports you have participated in: 

About Academics
High School Counselor:   Office Phone: 
Grade Point Average (4.0 scale): Class Rank: ACT/SAT score (s):
Intended Course of Study: 
If access to FAX please give the number:

Head Coach Wade Kooiman
 Dakota State University, 1302 N Washington, Ave. 57042

 
 

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If you have any questions please email Coach Kooiman
Last Updated 11/20/2007