Questionnaire

Contact Information
First Name	Last Name	M.I.
Mailing Address
City	State	Zip
Phone	Cell Phone	E-mail
Personal Information
Date of Birth	Age
Height	Weight
Father's Name	Father's Occupation
Mother's Name	Mother's Occupation
High School Information
High School Name	Coach's Name	Coach's Phone
Graduation Date	GPA
ACT Score	SAT Score
Junior College/Previous Four-Year Institution Information
Name	Coach's Name	Coach's Phone
Graduation Date	*Note: Transfers from four-year institutions must obtain a release before CSC coaches can contact you.
Other Information
Prospective Major(s): From CSC Application	Major 1	Major 2
Have you applied for financial aid?	Y N
Have you registered with NCAA Clearinghouse?	Y N
Event 1	Time/Distance
Event 2	Time/Distance
Event 3	Time/Distance
Event 4	Time/Distance
Other Interests/Achievements

Security Code