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CSUB Women's Water Polo Prospective Athlete Questionnaire
If you are interested in CSU Bakersfield Women's Water Polo please respond to the following questions, giving as much information as possible. If you have any questions about the program, please contact Head Coach Jason Gall via email at jgall@csub.edu or by phone at 661-654-2614.

Required Fields in Bold

 
Contact Information

Full Name
 
Mailing Address
 
City
 
State
 
Zip
 
Home Phone
 
Cell Phone
 
Email
 
Father's Name
 
Father's Occupation
 
Mother's Name
 
Mother's Occupation
 
 
High School Information

High School
 
Location (City, State)
 
Year Graduating/Graduated
 
Position(s)
 
# of Years Played
 
Athletic Awards/Accomplishments
 
High School Coach
 
Coach's Contact Phone Number
 
Coach's Email
 
 
Club Information

Club Team
 
Position(s)
 
# of Years Played
 
Awards/Accomplishments
 
Club Coach
 
Coach's Contact Phone Number
 
Coach's Email
 
 
Previous College Information

Name(s) of College(s)
 
Location (City, State)
 
Did you compete in water polo at the college(s) listed above?
 
Yes
No
Athletic Awards/Accomplishments
 
College Coach(s)
 
Coach(s) Contact Phone Number
 
 
Coach(s) Email
 
 
Academic Information

SAT and/or ACT Scores (Please designate individual section scores for SATs)
 
Current Grade Point Average
 
Academic Interests (What would you like to study in college?)
 
 
Additional Information

Are you registered with the NCAA Clearinghouse?
 
Yes
No
Social Security Number
 
Height (feet and inches)
 
Please list your best swim event and time.
 
Please list any sports (other than water polo) that you have competitively participated in.
 
Do you know anyone who is attending or has attended CSUB?
 
Yes
No
If yes, please list name and relationship to you.
 
Please list your top five university choices in order of preference.
 
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