Track & Field Questionnaire

(* indicates a required field.)

* 1). Name
2). E-mail
* 3). Street Address
* 4). City
* 5). State
* 6). ZIP
* 7). Home Phone
* 8). Date of Birth (mm/dd/yy)
* 9). Age
* 10). Height
* 11). Weight
12). Parent's name(s)
* 13). School Currently Attending

*14). Current School Level	High School Junior College 4-year college/university
15). Date of graduation (mm/yy)
*16). Grade point average
17). Class rank
18). ACT score
19). SAT score
20). Preferred college major
21). Coach's name
22). Coach's phone
23). Places in district, regional, state
24). List your best marks in various events
25). Explain any injury incurred
26). Other sports in which you compete
*27). Have you registered with the NCAA Initial-Eligibility Clearinghouse? (If no, contact your guidance counselor who can obtain materials at no cost by calling the Clearinghouse at 319-337-1492).	Yes No