PROSPECTIVE ATHLETES
Prospective Athlete Questionnaire - Track and Cross Country
PERSONAL INFORMATION
Full Name:
Graduation Year:
Address:
City:
State:
Zip:
Cell Phone or
Other Phone:
Birth Date:
Father's Name:
Occupation:
Mother's Name:
Occupation:
Have any members of your family or friends attended Wartburg?
No
Yes
If so, who and when?
OPTIONAL ITEMS BELOW
Religious Preference:
Ethnic Origin:
ACADEMIC INFORMATION
High School:
HS Conference:
High School Address:
Guidance Counselor:
ACT or SAT Score:
Class Rank:
GPA:
Intended Major
in College:
What other colleges are you interested in?
ATHLETIC INFORMATION
High School Coach:
Coach's Phone:
Are you a transfer student?
No
Yes
If a transfer, what school?
Coach at previous college:
Coach's Phone:
SPORT-SPECIFIC INFORMATION
Honors in Cross Country or Track:
List Track Events and Best Time:
Best Cross Country Race:
Date:
Distance:
Time:
State Qualifier?
No
Yes
If yes, what event(s)?
40-yard dash Time:
Vert. Jump:
Weightlifting Marks:
Track or cross country
sport would you like to participate:
Cross Country
Indoor Track and Field
Outdoor Track and Field
Other high school sports:
Honors in those sports:
Contact E-mail
(REQUIRED)
:
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