For Prospective Western Connecticut Women's Basketball Student-Athletes

Tell us about yourself. This information will be forwarded to Head Coach Kimberley Rybczyk and give her notice that you are interested in playing at Western Connecticut State University.

General Information  
First Name:  
Last Name:  
Street Address:  
Zip Code:  
Mobile Number:  
Email Address:  
Current High School:  
Year of Graduation:  
Date of Birth (mm/dd/yyyy):  
PSAT Math:  
PSAT Verbal:  
SAT Math:  
SAT Verbal:  
Class Rank (## of ###):  
AP Classes Taken:  
Anticipated College Major:  
Interested in other College Varsity Sports:  



Family Information  
Name of Father:  
Occupation of Father:  
Employer of Father:  
Alma Mater of Father:  
Name of Mother:  
Occupation of Mother:  
Employer of Mother:  
Alma Mater of Mother:  
Name(s) of Siblings:  
Siblings Age(s):  
College Siblings attended (if any):  
Whom do you live with?:  



High School Information:  
HS Jersey Number  
HS Coach Name:  
HS Coach Phone Number:  
HS Coach Email:  
What other sports do you play in high school?:  
Recruiting Web Site or Video Link:  



AAU Information:  
AAU Team Name:  
AAU Coach Name:  
AAU Coach Phone Number:  
AAU Coach Email:  
Years Played AAU:  



Athletic Specific Information  
Primary Position:  
Secondary Position:  
Dominant Hand (left/right):   Left    Right
Points Per Game:  
Rebounds Per Game:  
Assists Per Game:  
Steals Per Game:  
Athletic Honors/Awards:  



Other Information:  
Fall Basketball League:  
Top Three Priorities in Your College Search:  

One Interesting Thing About You:

Do you know anyone currently at WCSU?  


Do you know any alumni from WCSU?