First Name:
Last Name:
Email:
Address:
City, State, Zip:
Province:
Country:
Gender:
Male
Female
Date of Birth:
Graduation Class:
Home Phone:
Cell Phone:
Father's Name:
Father's Email:
Father's Cell Phone:
College Father Attended:
Mother's Name:
Mother's Email
Mother's Cell Phone:
College Mother Attended :
High School:
Graduation Year:
GPA:
TOEFL (Int. Students Only):
SAT Math:
SAT Writing:
SAT Critical Reading:
Composite SAT Score:
Composite ACT Score:
When did you start 9th grade?:
What are the five most important criteria you will use during the college selection process?
1. 2. 3. 4. 5.
Swing Instructor:
Putting/Shrt Gm Instructor:
Trainer:
Sports Psychologist:
Other Coach:
*Please include golf course or facility affiliation for each teacher.
Home Golf Courses:
Top Five College Choices:
1. 2. 3. 4. 5.
Golf Accomplishments in the past 24 months
(date/tournament/scores/finish):
List upcoming tournaments that you are scheduled to participate in:
What year did you begin participating in serious competitive (regional and/or national multi-day) junior golf tournaments?
Do you currently have a college profile (academic/golf) posted on the Internet for coaches to review and if so, where? (AJGA, Junior Golf Scoreboard, etc.)
I am interested in learning more about the following program(s):
Annual
Six-Month
Hourly
Daily
All
AJGA member?
Yes
No
Registered for the NCAA Clearinghouse?
Yes
No
Would you like to receive a follow-up phone call from Road to College Golf?
Yes
No
If yes, please indicate who to call along with their phone number.
How did you hear about Road To College Golf
(includes person's name if applicable):
General Comments: