Introduction Section
Welcome to the UCLA Football questionnaire. Please complete all fields to the best of your knowledge.
Personal Information
First Name:
Middle Name:
Last Name:
Preferred Name:
Country:
Address Type:
Street Address:
City:
State:
Zip:
Grad Year:
Date of Birth:
Email Address:
Home Phone:
Mobile Number:
What is your connection to this university:
Parent(s) Information
Parent 1's First Name:
Parent 1's Last Name:
Parent 1's Gender:
Parent 1's Address (If Different):
Parent 1's City:
Parent 1's State:
Parent 1's Zip:
Parent 1's Occupation:
Parent 1's Email Address:
Parent 1's Cell Phone:
Parent 1's Business Ph.:
Parent 1's College:
Living With:
Siblings (Names & Age):
Parent 2's First Name:
Parent 2's Last Name:
Parent 2's Gender:
Parent 2's Address (If Different):
Parent 2's City:
Parent 2's State:
Parent 2's Zip:
Parent 2's Occupation:
Parent 2's Email Address:
Parent 2's Cell Phone:
Parent 2's College:
Living With:
Most Influential People in Your Life: (1)
Most Influential People in Your Life: (2)
Guardian Information
Guardian's First Name:
Guardian's Last Name:
Guardian's Address (If Different):
Guardian's City:
Guardian's State:
Guardian's Zip:
Gender:
Guardian's Occupation:
Guardian's Email Address:
Guardian's Cell Phone:
Guardian's Business Ph.:
Guardian's College:
Living With:
Academic Information
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School Name:
School Address:
School City:
School State:
School Zip:
School Phone#:
School Fax#:
Counselor's First Name:
Counselor's Last Name:
Counselor's Phone:
Counselor's Fax:
Counselor's Email:
GPA:
SAT Test Date:
SAT Composite:
ACT Test Date:
ACT Composite:
Class Rank:
Out Of
Intended Major:
Have you Joined the Eligibility Center?
Eligibility ID:
Athletic Information
Height
Weight (in lbs.)
Jersey #
Events
Positions
Offense
Offense
Defense
Defense
Specialist
Specialist
Athlete
Athlete
Other Questions
What is your favorite type of music? List some of your favorite genre and artists:
What are some of your favorite foods/meals?:
Are you dating anyone? If so, what is their name?:
List your favorite athletes:
Other than football, what sports or activities do you participate in?:
List any visits (unofficial or official) to other schools you have taken:
What is your preferred Jersey Number? :
List all of the reasons on why UCLA would be a good fit for you:
When you have completed this questionnaire please click submit questionnaire.
School Name:
OR :
State:
City:


Club Name:
Team Name:
Coach Last Name:
State:
City:


Club Name:
Team Name:
Club State:
Club Coach First Name:
Club Coach Last Name:
Club Coach Email:
Club Coach Mobile:

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