P&HCC Recruiting Questionnaire

The Patrick & Henry Community College Coaching Staff is dedicated to it’s student-athletes.
We look for students that are committed to excellence.

Contact Information

First Name: *
Last Name: *
Address Street 1: *
Address Street 2:
City: *
State: *
Zip Code: *
Daytime Phone: *
Cell Phone: *
Email: *

About You

What Sport(s) are you Interested in at PHCC?: *
To select multiple sports, hold the Control or Command button
Dominant Hand:
Number of Siblings:
Do you have Family or Friends who attended PHCC?:


High School: *
High School Address: *
City/State *
Phone Number: *
Guidance Counselor Name: *
Guidance Counselor Phone: *
When Do You Plan to Enter College?: *
ACT Score:
SAT Math:
SAT Verbal:
SAT Total:
Overall GPA (4.0 Scale): *
Class Rank:
Academic Honors:
Anticipated College Major?: *

Athletic History

High School Sports Played w/ Position: *
Statistics (Yearly & Career): *
School Records Held:
Are Video Tapes Available?: *
Has Anyone in Your Family Participated in College Atheltics? (Where & When): *
What do you know about PHCC?: *
What has been your Most Exciting moment while competing in High School Sports?:
What other schools are you interested in?:
Any previous injuries or medical history?:

Information About PHCC

Please Send me an Offical PHCC Application?  Yes No
Please Send me Financial Aid Information?  Yes No
Please mail me a PHCC Catalog?  Yes No
I'm Interested in Campus Visit Information?  Yes No

Questions & Comments


I certify that all information given in this questionnaire, supporting documents, and interviews is correct to the best of my knowledge. I understand that any false information, omissions or misrepresentations of facts called for in the recruitment process may disqualify my recruitment.