Lyon College

 Piper Volleyball Questionnaire

Name:    Birthdate:   Date:

Address:    City:  

State:  Zip:

Home Phone:   E-Mail Address:

Graduation Date:   Best time to be reached:

Name of Father/Guardian:   Occupation:

Home Phone: 

Name of Mother/Guardian:   Occupation:

Home Phone: 

High school attended:   City:   State:

High school coach's name:   Phone number:

High school tournaments you will attend:

Academic Counselor:   Phone number:

GPA:      SAT:    ACT:

Anticipated Area of Study: 

 Educational Goals:

Have you registered with the NCAA Clearinghouse?   Yes   No

Positions played:   Height:  Weight:

St. reach:   St. jump:   Jump with approach:

Videotape available?  Yes   No

Club Team:   Coach's Name:   Phone:

Club tournaments you will attend:

Volleyball experience:

Athletic honors:

Please list your current top 5 college choices
(They do not have to be in order of choice):

1.

2.

3.

4.

5.

Please print and return by mail to:

Justin Dee
Piper Volleyball
Lyon College
P.O. Box 2317
Batesville, AR 72503

Or click "Submit" to return by E-mail