UMBC

 

Prospective Student-Athlete Form

Email address *
First name *
Last name *
Address 1 *
Address 2
City *
State *
ZIP Code *

Personal Information

Social Security Number
Date of Birth
Today's Date

Family Information

Father:

First Name
Last Name
Occupation
Work Phone
Home Phone
E-Mail

Mother:

First Name
Last Name
Occupation
Work Phone
Home Phone
E-Mail

General:

Number of Siblings

High School and Academic Information

Graduation Date
High School Attended
H.S. Address 1
H.S. Address 2
H.S. City
H.S. State
H.S. Phone
Academic Counselor
Academic Counselor Phone
Anticipated Area(s) of Study

Test Scores

G.P.A.
SAT
PSAT
ACT

Men's Basketball Information

Position(s) Played
Points Per Game
Rebounds Per Game
Assits Per Game
Height
Weight
Athletic Achievements

High School Coach

First Name
Last Name
Phone
E-Mail

Club Team Information

Club Name
Coach's First Name
Coach's Last Name
Coach's Phone Number
Coach's Email
Please List Other Schools You Are Interested In
 
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