University of Wisconsin-River Falls

Prospective Student-Athlete Request for Information Form

If you are interested in Men's Basketball at UW-River Falls
and would like additional information, please fill out and submit the form below to Coach Jeff Berkhof.

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Last Name:

First Name:

Street1:

Street2:

City:

State:

Zip Code:

 
Area Code and Phone #:
Cell Phone #:
Your Email Address:
    
Birth Date (mm/dd/yyyy):
    

Parent(s) Name(s):

 

Parent(s) Occupations:

 


High School:
Graduation Year:
Coach's Name:
   
Coach's Phone:
    
Coach's E-mail:
    

Position:

 

Most Recent Level of Play:

 

Height:

Weight:

Grade Point Average:

ACT Score:

Academic Interest:
What Semester Do You Want to Begin?:

If You're a Transfer, From What School?:

 
Interest in UW-River Falls?:
Have You Applied to UW-River Falls?:
Have You Been Accepted to UW-River Falls?:
Athletic Honors, Awards, Stats:
If you have specific questions or additional requests, please use the box below.

For more information, write:
Jeff Berkhof
Men's Basketball Coach
Athletic Department
Hagestad Hall
410 S. Third St.
River Falls, WI 54022
or call
715/425-3726

University of Wisconsin - River Falls
410 South Third Street River Falls, WI USA 54022-5001 (715)425-3911
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