Introduction Section
Hello from the University of Illinois! We hope you and your family are doing well!

Our coaching staff has identified you as a top prospect and would love to get some information from you! The prompt return of this information will allow us to keep in touch and assist in opening several doors to you as a Fighting Illini!

Thank you for taking the time to fill out the following questionnaire! We look forward to connecting with you soon!
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:
Snapchat:
Twitter:
@
Instagram:
@
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 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)
Academic Information
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School Name:
School Address:
School City:
School State:
School Zip:
Counselor's First Name:
Counselor's Last Name:
Counselor's Phone:
GPA:
Intended Major:
Have you Joined the Eligibility Center?
Eligibility ID:
Club Information
Club Name:
Club Address:
Club City:
Club State:
Club Zip:
Club Coach:
Club Coach Cell:
Club Coach Email:
Athletic Information
Height
Weight (in lbs.)
Jersey #


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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:

Do you still want to add the prospect?