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:
    Home Phone Number:
    Father's Occupation:
    Father's Employer:
    Father's Work Phone:
    Mother's Occupation:
    Mother's Employer:
    Mother's Work Phone:
    Siblings:
     
    Education
     
    High School:
    City, State:
    School Phone:
    Graduation Date:
    GPA:
    Class Rank:
    ACT Score:
    SAT Score:
    Counselor:
    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

    Saturday, Apr 19
    SPORT LOCATION TIME MEDIA
    Track Lawrence, Kan. All Day
    Friday, Apr 25
    SPORT LOCATION TIME MEDIA
    Track Jonesboro, Ark. All Day
    Saturday, Apr 26
    SPORT LOCATION TIME MEDIA
    Track Jonesboro, Ark. All Day
    Saturday, May 3
    SPORT LOCATION TIME MEDIA
    Track Normal, Ill. All Day
    Saturday, May 10
    SPORT LOCATION TIME MEDIA
    Track Charleston, Ill. All Day
    Friday, May 16
    SPORT LOCATION TIME MEDIA
    Track Carbondale, Ill. All Day
    Saturday, May 17
    SPORT LOCATION TIME MEDIA
    Track Carbondale, Ill. All Day
    Sunday, May 18
    SPORT LOCATION TIME MEDIA
    Track Carbondale, Ill. All Day
    Thursday, May 29
    SPORT LOCATION TIME MEDIA
    Track Fayetteville, Ark. All Day
    Friday, May 30
    SPORT LOCATION TIME MEDIA
    Track Fayetteville, Ark. All Day
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