Chadron State College

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Wrestling

Questionnaire

Contact Information
First Name:
Middle Initial:
Last Name:
Mailing Address:
City:
State:
Zip:
Phone Number:
Cell Phone:
Email:
Personal Information
Father’s Name:
Mother’s Name:
High School Graduation Date:
Wrestling Information
Height:
Weight:
Weight Class:
Wrestling Honors:
Wrestling Coach’s Name:
Performance Record
Matches won Freshman year:
Matches lost Freshman year:
Matches won Sophomore year:
Matches lost Sophomore year:
Matches won Junior year:
Matches lost Junior year:
Matches won Senior year:
Matches lost Senior year:
Academic Information
High School Name:
Proposed Major:
GPA:
Rank in Class:
ACT Score:
SAT Score:
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1000 Main Street, Chadron, NE 69337 • 1-800-CHADRON