Women's Cross Country Questionnaire

Personal Information

Name:		Date of Birth:

Mailing Address:

City:		State:		Zip:

Email Address:

Phone Number:		Cell Phone:

Parent(s) Name:

Church Name:		Denomination:

Convenient Time and Day to Contacted By Telephone:

HS or College Attended:		Graduation Year:

City:		State:		Zip:

CUM GPA:		Class Rank:	of	ACT/SAT:

Possible College Major:

Academic Honors:

Times: 400:		800:		1500/1600:		3200:		4K:		5K:		10K:

State Meet Qualification In:

Coach:		Coach Phone:

Athletic Honors:

Other Athletic Interests:

What are you looking for in a school?

Other athlete we should contact:		Phone: