SDSM&T Track & Field - Cross Country Questionnaire

Name:

First

Last

SS#

Address:
Street

City State Zip
Phone Email:

Father's Name:

Occupation:

Mother's Name:

Occupation:

High School: Address: Phone:

High School Coach:

Phone:

GPA:

Class Rank: /

ACT/SAT (composite):

Graduation Date:

Planned Area of Study:

Height:

Weight:

Date of Birth:

Please list your best event and three best performances below.

Event:

Performance:

Date:

Site:

Please list other events and your top performance in each.

Please list any reoccurring illnesses or injuries that may have slowed your athletic progress.

Please list other sports and activities in which you have been involved during high school.