QUESTIONNAIRE
PERSONAL DATA
Legal Name: Last First Middle Initial Social Security Number: Email Address: Birthdate: Mailing Address: Street City State Zip Phone:
GOLF DATA
Meet Scoring Average: (Last Complete Season) Home Course: (Name and City) Current Handicap: Name of your current head coach: Home Phone: Coach's Email Address: Athletic honors received:
SCHOLASTIC DATA
Name of your High School: Cumulative Grade Point: Class Rank: ACT Score: (if available) Graduation Date and Year: 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: Andy Soper, Golf Coach 300 South 18th Street Estherville, IA 51334-2725
For more information contact Coach Soper at: asoper@iowalakes.edu
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