LEWIS-CLARK STATE CROSS COUNTRY

On-Line Recruiting Questionnaire

General Information

Name:        

Address:  

City:  State: Zip:

Birthday:         Gender:

EMAIL:  

Home Phone: 

CELL PHONE:

What are good days and times to call you?

Do you have Brothers and/or Sisters?  How many?

High School:  Graduation Date:

Parent(s)/Guardian(s)  Name:

You are currently a: 

Freshman   Sophomore  Junior  Senior  Junior College Student

Coach's Name:  

Phone:

Coach's E-mail:  

Is this HS or JC Coach?  High School     Junior College

Junior College (if applicable):   

Will you have earned you AA Degree upon Transfer?  Yes      No       Unsure 

Academic Information

Current GPA:

High School Class Rank (For Example: 44th out of 90):

ACT Scores:  Math:  English:  Reading:  Science:

SAT Scores:  Math: Verbal:

Have you applied for admission to LCSC? Yes   No

Potential College Major(s):

Athletic Information

Height:          Weight: 

Please put in your personal best time for any distances that may apply to you.

400M:  

800M:  

1500M:

1600M   

3000M:  

3000M Steeple:

3200M Track: 

3200M XC:  

5000M Track:

3 Mile XC:  

5000M XC: 

8000M XC:

10000M Track: 

10000M XC: 

10000M Road:

Other:

Other sports you are involved in:

Honors/Awards you have received:

Other extracurricular activities:

Any other important information you want to share with me:

Thank you for your interest in becoming a warrior.  I will contact you after receiving this information.

            --Mike Collins, Ph.D., Head Coach