PHCC Recruiting Questionnaire

Contact Information

The Patrick Henry Community College Coaching Staff is dedicated to it's student-athletes. We look for students that are committed to excellence.
- If you are interested in becoming a PHCC Patriot, we would like to hear from you.
- Please complete and submit the form below
- This form is not an official PHCC Application

Today's Date:
What Sport(s) are you Interested in at PHCC?: *
First Name: *
Last Name: *
Address Street 1: *
Address Street 2:
City: *
Zip Code: *	(5 digits)
State: *
Daytime Phone: *
Cell Phone: *
Email: *
Height:
Weight:
Dominant Hand:
Number of Siblings:
Do you have Family or Friends who attended PHCC?:
High School: *
High School Address: *
City/State *
Phone Number: *
Guidance Counselor Name: *
Guidance Counselor Phone: *
When Do You Plan to Enter College?: *
ACT Score:
SAT Math:
SAT Verbal:
SAT Total:
Overall GPA (4.0 Scale): *
Class Rank:
Academic Honors: *
Anticipated College Major?: *
High School Sports Played w/ Position: *
Achievements/Awards:
Statistics (Yearly & Career): *
School Records Held:
Are Video Tapes Available?: *
Has Anyone in Your Family Participated in College Atheltics? (Where & When): *
What do you know about PHCC?: *
What has been your Most Exciting moment while competing in High School Sports?:
What other schools are you interested in?:
Any previous injuries or medical history?:
Please Send me an Offical PHCC Application?	Yes No
Please Send me Financial Aid Information?	Yes No
Please mail me a PHCC Catalog?	Yes No
I'm Interested in Campus Visit Information?	Yes No
Comments: