Kansas Track Questionnaire

Personal Information:
SSN #
Name (first, mi, last)
Address
City, State, Zip Code
Email Address
Home Phone Number
Alternate Phone Number
Birthdate
Height
Weight
Father's Name and Occupation
Mother's Name and Occupation
Scholastic Information:
Name of High School
High School Address
Rank in Class
GPA
Graduation Year
Academic Interest
ACT Score and Date Taken
SAT Score and Date Taken
Are you registered with the NCAA Clearinghouse?
Coach
Coach's Home Phone
Coach's Office Phone
Principal
Principal's Office Phone
Athletic Information:

Please list any serious injuries:

List other sports in which you participate:

List best marks in each event in which you compete:

60M
100M
200M
400M
800M
1500M
1600M
3200M
XC
XC Distance
60M Hurdles
100/110 Hurdles
300M Hurdles
400M Hurdles
Triple Jump
Long Jump
High Jump
Pole Vault
Shot Put
Discus
Javelin
Other

Please List the names of the best athletes against whom you have competed (Include name, grade, event, best mark, school, city/state)
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