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Baseball Questionnaire
 
Please complete the following form with all available information. Hit the SUBMIT button at the bottom to electronically submit. If submitting an application by mail, please type or print all answers and mail to address listed at the bottom. 

PERSONAL DATA

Legal Name:  Last    First   
     Middle Initial
Social Security Number:   
Marital Status: 
Email Address:
Date of Birth: 
Mailing Address:   Street 
City      State       Zip 
Phone:

BASEBALL DATA

Height:  Weight:    
Throw Left or Right: 
Hits Left, Right or Switch Hitter:    
Batting Average:
Best College Position:   
Baseball Honors Received:
Number of Years Lettered at Varsity:   60 Yard Speed:
Arm Strength:
Name of your current head coach:   
Home Phone: 
Office Phone:    Are video tapes available? Yes No
Coach's Email Address: 
Other Athletic honors received: 

SCHOLASTIC DATA

Name of your High School:    
School Address: Street 
City      State       Zip 
Cumulative Grade Point:    Class Rank:    
ACT Score: (if available) 
Graduation Date and Year:    
School Phone: 
Have you filed the Family Financial Statement Packet: Yes  No  
Date Filed: 
EFC#:    Counselor's Name:    
Academic Interest Area(s): 

FAMILY DATA
Mother's Name:  
Address:  
Street 
City      
State        
Zip   
Telephone #:
Father's Name: 
 
Address:  
Street 
City      
State        
Zip    
Telephone #:
Brothers & Sisters: (Names & Ages)

Marital Status of Your Parents
 Married
 Separated
 Divorced
 Deceased

Name/Signature:   Date: 

You may choose to submit this application electronically, or by mail, to:
Jason Nell
Head Baseball Coach
300 South 18th Street
Estherville, IA 51334-2725

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Campuses in Algona, Emmetsburg, Estherville, Spencer and Spirit Lake.
Questions or comments? Please email us at info@iowalakes.edu or call 712-362-2604 or 800-521-5054.
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