CLEVELAND STATE COMMUNITY COLLEGE
P.O. Box 3570
Cleveland, TN 37320-3570

Coach Dan Lumpkin
Women's Basketball Coach

Women's Basketball Prospect Questionnaire


Personal Information

Name
Address
City
State
Zip Code
Home Phone Number
Date of Birth
Cell Number
Mother
Father
Mother's Occupation Phone Number:
Father's Occupation Phone Number:
Sister(s) - Age(s)
Brother(s) - Age(s)


Academic Information

High School   Graduation Date:
ACT/SAT Score
GPA
Address
City  State  Zip Code
School Phone Number Guidance Counselor:
Major Interest
 

Athletic Information

Position  Height Weight
Points Per Game Rebounds Per Game Assists Per Game
Field Goal %  3 PT % FT %
Team Record   Team Honors:
Head Coach
Home Phone Number  School Phone Number
AAU Program  Head Coach
Home Phone  Office Phone