PERSONAL INFORMATION
Full Name:
Address:
City:
State:
Home Phone:
Cell Phone:
Email Address:
Birth Date:
Mother's Name:
Father's Name:
Brothers/Sisters - Name and Ages:

ACADEMIC INFORMATION
High School:
High School Coach:
High School Address:
Year of Graduation:
Grade Point Average:
Class Rank/Total:
ACT Score:
SAT Score:
College Academic Interest (Intended Major):
Have you been cleared by the NCAA Clearinghouse?	YES NO

ATHLETIC INFORMATION
Current Handicap Index:
Home Course:
Rating/Slope:
Golf Instructor:
Facility:
How often do you visit?:
Current Equipment Brand/Set Make Up:
Distances:
Driver:
7 Iron:
PW:
Best Tournament Finish (last 30 days):
Describe:

Best Tournament Finish (last 6 months):
Describe:

Other Tournaments:
Describe:

Golf Goals (next 6 months):

Golf Goals (College):

Golf Goals (Post College):