Adrian College Athletics
Men's Basketball Questionnaire

Are you interested in playing basketball for Adrian College? If you are, please fill out our online inquiry form and our coach will contact you soon. Fields with an * are required.
First Name *
Last Name *
Address *
City *
State *
Zip *
Email
Home phone *
Cell Phone
Birthdate (MM/DD/YYYY)
Mother's Name    Occupation
Father's Name    Occupation
Any Adrian Alumni/Current Students you know?
Academic Information  
High School *
High School Graduation Year *
GPA
ACT/SAT Score
Class Rank
Academic Interests
Clubs / Organizations / Awards
Guidance Counselor    Phone Number
Other colleges you are considering?
Basketball Information  
Position *
Height
Weight
Jersey Number
School Colors
PPG
RPG
Assists
Are Tapes Available?

If available, please send to:
Buck Riley, Head Basketball Coach
Adrian College
110 S. Madison St., Adrian, MI 49221
Athletic Honors
Coach's Name
Coach's Office Phone
Coach's Email
Have you already applied to Adrian College? Yes No     *