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Athletics Dept. - Track & Field Questionnaire

Please fill in the following information:

Last Name
 First Name
 Middle
 Nickname
Street Address
City
   State
 Zp Code
Home (area code) and phone
 Your e-mail address
   
Guardian:Father
 Mother
Guardian's Occupation
 Title
 Employer
Your birth date
 Graduation date
Planned course of study
Test scores: SAT
 ACT
 Grade Point Average
 Class Ranking
Height
 Weight
 Championships Won:
 
Track Events (ex. 400m, 110m Hurdles, 1500m, etc.):
  Track Event 1:
 Best Time 1:
  
  Track Event 2:
 Best Time 2:
  
  Track Event 3:
 Best Time 3:
  
Field Events (ex. High Jump, Triple Jump, etc.):
  Field Event 1:
 Best Height or Distance 1:
  
  Field Event 2:
 Best Height or Distance 2:
  
  Field Event 3:
 Best Height or Distance 3:
  
Weight Events (ex. Shot Put, Discus, etc.):
  Weight Event 1:
 Best Distance 1:
  
  Weight Event 2:
 Best Distance 2:
  
  Weight Event 3:
 Best Distance 3:
  
       
High School Attended

School Address
City

State

 Zip
School Phone
 Athletics Phone
Coach's Name
 Coach's Home Phone
Other Sports (with positions and/or events)
Athletic Honors:
Friends or Relatives Who Attended or Are Attending BC:
Injuries? (Explain)
Other than your parents, who is the most influential person in your life?

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