Track & Field and Cross Country Questionaire

Personal Information

Name
 Preferred First Name

Address

City
 State
 Zip

Email Address
 Date of Birth

Home Phone
 Cell Phone

High School
 Graduation Date

Father's Name
 Occupation
 Mother's Name
 Occupation


Academic Information
Cumulative GPA
 Class Rank
 # In Class

SAT Score (CR)
 SAT Score (M)
 SAT Score (WR)

ACT Score

Academic Honors

Planned College Major


Athletic Information
High School Coach's Name

Please provide your top performances in the events listed below that you have competed in:

100
 200
 400

800
 1600
 3200
 XC(5 kilometer)

110 & 100 Hurdles
 300 Hurdles

Long Jump
 Triple Jump
 High Jump
 Pole Vault

Shot Put
 Discus
 Javelin
 Hammer

Track & Field/Cross Country Honors/Awards

Other Sports in which you participate