Prospective Student Athlete Form

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Pirate Athletics > Men's Basketball > Prospective Student Athlete Form

Prospective Student Athlete Form

Fill out form accurately and thoroughly.

Biographical Info
First Name:
Last Name:
Address:
City:
State:
ZIP:
Phone Number:
E-mail:
High School:
Grade:
H.S. Coach:
Parent/Guardian:
Athletic Information
Height:
Weight:
Position:

Physical Attributes (Speed, Strength, Accuracy)

Statistical Highlights

Awards/Recognitions

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QUICK FACTS:

Location: Independence, Kansas

Founded: 1925

Colors: Navy Blue & Vegas Gold

Mascot: Pirate

Conference: Kansas Jayhawk East

National Affiliation: NJCAA

President: Dr. Daniel Bain

Athletic Director: Mick Wilson

Independence Community College Athletics

1057 W. College Ave.

Independence, KS 67301

620.332.5481

Toll Free 800.842.6063

FAX 620-331-0153

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