Track & Field | Cross Country Questionnaire

Personal Information:

Full Name:  Last:      First:     Middle:  Sex:

Address:  Street:     City:     State:     Zip:     

Home Phone:     Cell Phone:     E-mail:    
Date of Birth:     Birthplace:       

Father's Name:       
Father's Address: (if different than above)  Street:      City:      State:      Zip:      
Father's Occupation:      
Mother's Name:       
Mother's Address: (if different than above) Street:      City:      State:      Zip:      
Mother's Occupation:         

Academic Information

High School Name:     County: 
School Address: Street:       City:       State:      Zip:       
School Phone:      Head Coach:     Office Phone:      
Guidance Counselor:
Your Graduation Date:    Overall GPA:    Class Rank:     SAT score (total):    SAT score (math):      ACT Score (Composite): 
Intended major in College:     
Have you registered with the NCAA Eligibility Center: yes   or no 

Athletic Information

Height:       Weight:       

Event:   Best mark/time:     Year:   
Event:   Best mark/time:     Year: 
Event:   Best mark/time:     Year: 
Event:   Best mark/time:    Year: 

Cross Country Distance:    Best time:   Year: 

Do you plan on participating in any other sports in college? If so, please list sport(s).

Transcript Release: I give my consent for a copy of my transcript and avaialable test score to be released to Ashland University.

Student Athlete:     Parent or Guardian: