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Recruiting Questionnaire

* = Required Field

Contact Information
* Name:      
First                         M.I.            Last
* Street: 
* City:   * State:  * Zip: 
*Home Phone:  () -   Cell Phone:  () -  
* Email: 

Education-Related Information
High School:
City:  State: 
Graduation Date:
Month:  Year: 
GPA:    Class Rank: 
Reading SAT:    Math SAT:     ACT: 
Status:
Tentative Major(s):
Other Colleges
Considering:
Academic Honors:

Athletic Information
* Gender:
* Height: ' "
* Weight: lbs.
* 3 Mile Time: : :
* 5K Time: : :
 
Track
 
Track Event:
Best Time:: :
 
Track Event:
Best Time:: :
 
Track Event:
Best Time:: :
 
Track Event:
Best Time:: :
 
School Coach's Email:
School Coach's Phone: () -  
Club Team:
Club Coach's Email:
Club Coach's Phone: () -  

Other Information
Parent Status:Married  Divorced  Other  
Father's Name: Occupation:
Mother's Name: Occupation:
Do you currently have a brother
or sister enrolled in college?		Yes  No  
If yes, please list the name
of the school attended:
Will you be applying for
need based financial aid?		Yes  No  
Do you know anyone who
is enrolled at Susquehanna
presently or has
attended Susquehanna?
If so, list names:

 
Susquehanna University Last reviewed by Athletics Communications
Crusaders Athletics; James W. Garrett Sports Complex
©2004 Susquehanna University, Selinsgrove, PA 17870