Please fill out ALL of the fields in the form below. If a question does not apply to you, simply put N/A in the box.

Personal and Contact Information

Email From:   

First Name:    

Last Name:     

Address 1:      

Address 2:      

City:                

State:              

Zip Code:        

Country:         

Telephone:     

Birth Date:      

Height:            

Weight:           

Academic Information

Academic Area of Interest at Wilberforce:

High School Name:                     

High School Graduation Year:    

High School GPA:                        

SAT Math:                                    

SAT Verbal:                                 

ACT Composite:                           

TOEFL (foreign students only):  

Academic Honors:         

High School Athletic Experience

Letters Won in Basketball:    

High School Coach:                

Coach's Telephone:               

Position:     

Stats, Honors and Team Highlights:

Other Sports You Participated In:

Summer League/Club Program Participation

Team Name:        

Coach's Name:    

Coach's Phone:   

Stats, Honors and Team Highlights:

Additional Information

Why Do You Want to Compete for Wilberforce?

Other Colleges You Are Considering:

Additional Comments or Questions: