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, May 6
    SPORT LOCATION TIME MEDIA
    Track Bloomington, Ind. All Day
    Saturday, May 7
    SPORT LOCATION TIME MEDIA
    Track Bloomington, Ind. All Day
    Friday, May 13
    SPORT LOCATION TIME MEDIA
    Track Terre Haute, Ind. All Day
    Sunday, May 15
    SPORT LOCATION TIME MEDIA
    Track Terre Haute, Ind. All Day
    Thursday, May 26
    SPORT LOCATION TIME MEDIA
    Track Lawrence, Kan. 4:30 PM
    Wednesday, June 8
    SPORT LOCATION TIME MEDIA
    Track Eugene, Ore. 12:30 PM