Baseball Questionnaire

Personal and Academic Information:

Full Name: Social Security Number: E-mail Address:
Permanent Address: City, State and ZIP: Home and Cell Phone Numbers:
Birth Date (MM/DD/YYYY): Height: Weight:
Parent/Guardian's Name(s): Parent/Guardian's Occupation(s): Name of High School:
High School Address: City, State and ZIP: High School Phone Number:
High School Coach's Name: H.S. Coach's Phone Number: Grade Point Average:
High School Graduation Date: Rank in Class: Areas of Academic Interest:
ACT or SAT Score: Academic Awards/Honors/Etc:  

Baseball Information:

Positions Played: Preferred Position: Bats and Throws:
Summer Team: Summer Team City, State, ZIP: Summer Coach's Name:
Summer Coach's Phone Number: Varsity Letters Earned: Baseball Honors/Awards/Etc:
60 Yd. Time: Home to 1B Time: Gun Time/Type of Gun:

List any professional scouts that have seen you play:
Please include scouts' organizations and phone numbers.

Statistics (record high school varsity stats only):

Pitchers (11th Grd.)

Hitters (11th Grd.)

Pitchers (10th Grd.)

Hitters (10th Grd.)

Pitchers (9th Grd.)

Hitters (9th Grd.)

Send a VIDEO TAPE of yourself in BASEBALL ACTION to:
Barton County Community College
Baseball Office
245 NE 30th Road
Great Bend, KS 67530

(Video tapes will be returned when evaluation is complete.)

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