IBC Foundation Scholarship Fund

Name *

First Name

Last Name

Phone *

(###)

###

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Gender *

Male

Female

High School Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

High School Phone *

(###)

###

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Guidance Counselor *

First Name

Last Name

Graduation Date *

MM

DD

YYYY

ACT or SAT *

ACT

SAT

ACT or SAT Test Date *

MM

DD

YYYY

Did you play basketball for your high school team? *

Yes

No

What year(s) did you play for your high school basketball team? *

Select all that apply

Freshman

Sophomore

Junior

Senior

Basketball Coach's Name *

First Name

Last Name

Basketball Coach's Phone *

(###)

###

####

Do you plan on playing basketball in college? *

Yes

No

Have you already been accepted to a college, university, or trade school? *

Yes

No