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Women's Cross Country Recruit Questionnaire

Personal Information

Email address *
First name
Last name
Address 1
Address 2
City
State
ZIP Code
Date of Birth:
Phone Number:
Cell Phone:
Permanent Address:
City:
State:
Zip Code:

Family Information

Father

First Name:
Last Name:

Mother

First Name:
Last Name:
Have any members of your family previously attended BHSU?
  Yes
  No
If so, when?

High School Academic Information

High School:
State:
Phone Number:
Graduation Date:
High School Academic Accomplishments:
GPA:
Class Rank:
ACT/SAT Score:
Interest of Study at BHSU:
Are you a transfer student?
  Yes
  No

If yes, fill out the following information.

If no, then skip these questions.

School attended:
Dates Attended:
Number of full time quarters/semesters completed:
College GPA:
Will you receive an A.A. degree?
  Yes
  No
If yes, what term/year:

Athletic Information

Coach's Name:
Coach's Phone:

Track Program Information

Events and Top 2 Performers each:
Awards/Accomplishments:
Why are you interested in BHSU?

Other Athletes You Know Who Might Be Interested in Black Hills State University:

First Name:
Last Name:
Phone:
Email:
Address:
City:
State:
Zip Code:
* = required field