Questionnaire

Please know that this page runs through a secure server. The following questionnaire will be emailed directly to Tammie Jimenez in the Midland College Volleyball office. If you prefer, you can request a hard copy questionnaire by phone or email.

Email: tjimenez@midland.edu -- Phone: 432-685-4650

PERSONAL

Full Legal Name

Parent(s)/Legal Guardian

Home Phone Cell Phone

Home Address City Zip Code

Date of Birth Email Address

Have you filed for financial aid? Yes Not Yet Will Not

If you have filed for financial aid, did you qualify for any of the following (please check all that apply)?

Pell Grant Work Study Student Loans Not sure No aid

ACADEMIC

High School G.P.A.

ACT (if taken) SAT (if taken)

Graduation Date: 2015 2016 2017 2018

Academic Interests

ATHLETIC

Height Weight

Primary position:
Left-side Hitter Right-side Hitter
Middle Blocker Setter Defensive Specialist Libero

Secondary position:
Left-side Hitter Right-side Hitter
Middle Blocker Setter Defensive Specialist Libero

Dominant Hand: Right Left

Standing Reach Block Touch
Approach Touch

USAV Team

USAV Coach Phone

High School Coach Phone

Other sports participated in

Athletic Honors

Other Information

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