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Men's Basketball Prospective Players

Basketball Header

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.

Indicates a Required Field
Last Name:
First Name:
Middle Initial:
Social Security Number OR last four digits:
Marital Status:
Email Address:
Date of Birth:
Street Address:
City:
State:
Zip:
Phone Number:
Height:
Weight:
Position(s) Played:
College Positions:
Stats: Pts.:
Stats: Reb.:
Stats: Asst.:
Stats: FT%:
Stats: 3 pt. %:
Does your team fast break?:
Yes
No
Primary Defense Used:
Other sports participated in & number of years:
Name of your current head coach:
Coach's Office Phone:
Coach's Home Phone:
Coach's Email Address:
Athletic Honors Received:
Name of your high school:
High school street address:
High school city:
High school state:
High school zip:
High school phone:
Cumulative Grade Point:
Class rank:
ACT Score (if available):
Graduation Date and Year:
Filed the Family Financial Statement Packet?:
yes
no
Date filed:
EFC #:
Counselor's Name:
Academic Interest Area(s):
Mother's Name:
Mother's Street Address:
Mother's City:
Mother's State:
Mother's Zip:
Mother's Phone Number:
Father's Name:
Father's Street Address:
Father's State:
Father's Zip:
Father's Phone Number:
Marital Status of Your Parents:
Married
Separated
Divorced
Deceased
Brothers & Sisters (Names & Ages):
Name / Signature:
Date:
Verification Code:
Questions or comments? Please email us at info@iowalakes.edu or call 712-362-2604 or 800-521-5054.
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