In addition to this questionnaire, please send a DVD/VHS of you in action. Thank you for your attention to this matter. If you have any questions please contact us at your convenience. Please send your video to Oregon State University, Laura Benzing - Assistant Coach, 112 Gill Coliseum, Corvallis, OR 97331. Required Fields in Bold.

Student Athlete Information

Today's Date

Full Name

Birth Date

Social Security Number

Phone Number (Home & Cell)

Address

Email/Personal Website

Instant Messenger Address

Father's Name

Father's Occupation

Mother's Name

Mother's Occupation

Parent's Address

Parent's Email

Academic Information

High School

High School Address

High School Phone

Year in School

Graduation Date

Cumulative GPA

Have you registered with the NCAA clearinghouse? (If no, call 800-638-3731 to register)
Choose One Yes No

Have you taken the PSAT/SAT test? (Please give the date and score)

Have you taken the ACT test? (Please give the date and score)

What are you considering as a major course of study?

Academic Achievements/Awards

List the top five universities you are considering:

Athletic Information

Position

Height

Weight

Reach

Block Jump

Approach Jump

Dominant Hand

High School Coach

High School Phone

High School Email

Club Team

Club Name

Club Coach Phone

Club Coach Email

Club Website

Upcoming Matches/Tournaments

Other sports you participate in

Athletic Awards

Level of Interest in Oregon State
Choose One Top Choice Top 5 Top 10

Please Verify the Charactes Before Submitting Your form: