Track & Field

Questionnaire

Contact Information
First Name:
Middle Initial:
Last Name:
Mailing Address:
City:
State:
Zip:
Phone Number:
Cell Phone:
Email:
Personal Information
Date of Birth:
Age:
Height:
Weight:
Father’s Name:
Father’s Occupation:
Mother’s Name:
Mother’s Occupation:
Parent’s Mailing Address:
High School Information
High School Name:
Coach’s Name:
Coach’s Phone Number:
Graduation Date:
Cumulative GPA:
ACT Score:
SAT Score:
Junior College/Previous Four-Year Institution Information
Name of Previous School:
Coach’s Name:
Coach’s Phone Number:
Graduation Date:	*Note: Transfers from 4-year institutions must obtain a release before CSC coaches can contact you.
Other Information
Prospective Major from CSC Application:
Have you applied for financial aid?:	Yes No
Have you registered with the NCAA Clearinghouse?:	Yes No
Event 1:
Event 1 Time/Distance:
Event 2:
Event 2 Time/Distance:
Event 3:
Event 3 Time/Distance:
Event 4:
Event 4 Time/Distance:
Other Interests/Achievements:
Please enter the following code:

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