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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