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LEWIS-CLARK STATE CROSS COUNTRY
TRACK & FIELD
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:
HS Freshman HS Sophomore HS Junior HS Senior Junior College Student
Coach's Name: Phone:
Coach's E-mail:
Is this HS or JC Coach? High School Junior College
Name of 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 or a percentage- 33% = top 1/3 of class):
ACT SCORES: Math: English: Reading: Science:
SAT SCORES: Math: Critical Reading: Writing:
Have you applied for admission to LCSC? Yes No
Potential College Major(s):
Athletic Information
Height: Weight:
Please put in your personal best mark for any events that may apply to you.
MIDDLE AND LONG DISTANCE RUNNING EVENTS
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:
If a distance runner, how many miles per week are you used to running?
SPRINT AND FIELD EVENTS
Long Jump High Jump Triple Jump
Pole Vault Shot Put Javelin
Discus Hammer Weight Throw
100/110 Hurdles 400 Hurdles 400M:
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.
--Michael G. Collins, Ph.D., Head Coach