Southern State Community College Athletics
Prospective Student Athlete Questionnaire
GENERAL INFORMATION
Nam
e: Nickname:
Address:
City: State: Zip:
Phone: _ Mobile: E-mail:
Date of Birth: Parent/Guardians’ Name:
ATHLETIC INFORMATION (High School)
Sport(s):
Position(s): ________
Statistics:
Team Records (last season of participation):
Athletic Honors:
ATHLETIC INFORMATION (Club Team)
Club Team Name: City:
Position(s): Team Record:
ATHLETIC INFORMATION (Previous College)
College Name: Sports:
Position(s): Team Record:
COACH’S INFORMATION: (List All: High School, Club, College)
High School Coach: Phone:
Club Coach: Phone: _
College Coach: Phone: _
ACADEMIC INFORMATION (High School or College Transfer)
High School/College: GPA: Graduation Year:
Address: City: State: Zip:
Intended Major/Major:
or email to athletics@sscc.edu
