Southern Illinois Track & Field Recruiting Questionnaire

    General Information
     
    First Name:
    Last Name:
    Date:
    Address:
    City, State:
    Zip Code:
    Date of Birth:
    Phone Number:
    Cell Phone:
    Email:
    Height:
    Weight:
     
    Family Information
     
    Father:
    Mother:
    Father's Occupation:
    Mother's Occupation:
    Siblings:
     
    Education
     
    High School:
    City, State:
    Graduation Date:
    GPA:
    Class Rank:
    ACT Score:
    SAT Score:
    Intended Major or Academic Interest:
    Academic Honors:
    Have you applied to the NCAA Clearing House?Yes No
    Have you applied for admission to SIU?Yes No
    Do you know any SIU students/graduates?Yes No
     
    Coach Information
     
    Coach:
    Coach Number:
    Other sports you competed in during high school:
     
    Best Times/Marks
     
    Event:  Time/Mark:  
    Event:  Time/Mark:  
    Event:  Time/Mark:  
    Event:  Time/Mark:  
    Event:  Time/Mark:  
    Event:  Time/Mark:  
    Event:  Time/Mark:  
    Event:  Time/Mark:  
    Event:  Time/Mark:  
    Event:  Time/Mark:  
    Relay Splits:
    Relay Splits:
    Relay Splits:
     
    Athletic Achievements and Accomplishments

    Friday, Jan 30
    SPORT LOCATION TIME MEDIA
    Track Bloomington, Ind. All Day
    Saturday, Jan 31
    SPORT LOCATION TIME MEDIA
    Track Bloomington, Ind. All Day
    Friday, Feb 6
    SPORT LOCATION TIME MEDIA
    Track Carbondale, Ill. 9:30 AM
    Saturday, Feb 7
    SPORT LOCATION TIME MEDIA
    Track Carbondale, Ill. 9:00 AM
    Saturday, Feb 14
    SPORT LOCATION TIME MEDIA
    Track West Lafayette, Ind. All Day
    Friday, Feb 20
    SPORT LOCATION TIME MEDIA
    Track Charleston, Ill. All Day
    Saturday, Feb 28
    SPORT LOCATION TIME MEDIA
    Track Cedar Falls, Iowa All Day
    Sunday, Mar 1
    SPORT LOCATION TIME MEDIA
    Track Cedar Falls, Iowa All Day
    Friday, Mar 13
    SPORT LOCATION TIME MEDIA
    Track Fayetteville, Ark. All Day
    Saturday, Mar 14
    SPORT LOCATION TIME MEDIA
    Track Fayetteville, Ark. All Day
    SIU