FSC Cross Country/Track Questionnaire

Moccasin Men's Cross Country / Track

Cross Country/Track Questionnaire for Potential Student-Athletes

PERSONAL INFORMATION
Male: Female:
Name (Last, First, MI):
Nickname:
Street Address:
City:
State:
Zip:
Home Telephone:
Cell Phone:
E-Mail Address:
Birthdate:
Father's Name:
Father's Occupation:
Mother's Name:
Mother's Occupation:

ACADEMIC INFORMATION
Name of School Presently Attending:
School Address (Street):
City:
State:
Zip:
High School Telephone:
Current Coach:
Current Coach's Phone:
Current Coach's Email:
Guidance Counselor:
High School Graduation Date:
GPA:
Class Rank:	Out of
ACT Score:
SAT Score:
Intended College Major:
What do you want to study in College?:	1st Choice:
	2nd Choice:
What other schools are you interested in visiting or attending?:

ATHLETIC INFORMATION
Personal Best Cross Country/Track & Field Times and Marks
Event: Time:
Event: Time:
Event: Time:
Event: Time:
Event: Mark:
Event: Mark:
List any All-Conference, All-District, All-Sectional, All-State, All-Region, or any other honors and award you have received:
Other Sports and/or Activities you have participated in: