Merrimack Men's Basketball Recruiting Questionnaire
ATTN: Head Coach Bert Hammel, Asst. Coach Micky Burtnyk
315 Turnpike St.
North Andover, MA 01845

This form is not an official college application.
 

Recruiting Questionnaire

 

Personal Information

 

Name:
Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Email:
Date of Birth:
Parents' Names
Parents Email
Father's Occupation
Mother's Occupation

 

Academic Information

 

High School Name:
College Name
(if applicable)
High School Address:
High School Phone:
Guidance Counselor:
Expected High School Graduation Month/Year:
Intended major at Merrimack:
High School Grade-Point Average:
College Grade-Point Average:
(if applicable)
Class Rank: of
SAT Score (verbal and math):
ACT Score:
Do you plan to take either test again? Yes No
If yes, which one and when?
Have you registered with the NCAA Clearinghouse? Yes No
Have you ever applied to Merrimack College? Yes No
Do you intend to apply for financial aid at Merrimack? Yes No
Academic Honors: (all-conference, all-america, etc)
Other colleges you are Interested in:

 

Athletic Information

 

Height:
Weight:
Current High School:
Letters Won In This Sport:
HS Coach's Name:
HS Coach's Email
HS Coach's home Phone:
HS Coach's cell phone:  
Position/Event:
AAU Team:
AAU coach's Name:
AAU coach's Email:
AAU coach's Cell Phone:
AAU coach's Home Phone:
PPG:
RPG:
APG:
Athletic Honors (all-conference, all-state, all-area, etc.):
Team Highlights in career: