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PERSONAL INFORMATION

Today’s Date
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Last Name
Address 1
Address 2
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Date of Birth

Are you registered with the NCAA Clearinghouse?

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FAMILY INFORMATION

Father
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Last Name
Occupation
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Mother
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Last Name
Occupation
Work Phone
Home Phone
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Number of Siblings

HIGH SCHOOL AND ACADEMIC INFORMATION

Graduation Date
High School Attended
H.S. Address 1
H.S. Address 2
H.S. City
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H.S. Phone
Academic Counselor
Counselor Phone
Anticipated Area(s) of Study

TEST SCORES

G.P.A.		PSAT
SAT		ACT

WOMEN'S GOLF INFORMATION

Best Rounds
Course Name		Score/Par
Course Name		Score/Par
Course Name		Score/Par
Course Name		Score/Par
Course Name		Score/Par

Please List Athletic Achievements

HIGH SCHOOL COACH

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Last Name
Phone
E-Mail

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Why Are You Interested in Sacramento State?