Lake Superior
State University
Cross Country / Track and Field Questionnaire Thank you for your interest in Lake Superior State University cross country and track. By completing this questionnaire, you are indicating an interest in competing on the Laker Cross Country and/or Track and Field team. This form in no way binds you to LSSU or to any agreement. Please complete, refold and tape with business reply showing. PERSONAL INFORMATION Name________________________________________ Phone _____________________________________ Home Address ________________________________ City _______________________________________ State ____________________ Zip ________________ E-Mail Address ______________________________ County __________________ Birthdate ___________ Social Security ______________________________ Father’s Name ________________________________ Occupation_________________________________ Mother’s Name________________________________ Occupation_________________________________ Names and Ages of Siblings_________________________________________________________________ ACADEMIC INFORMATION High School __________________________________ Address/City ________________________________ H.S. Counselor ________________________________ Year of Graduation __________________________ GPA ____________________ Class Rank/Size ___________________ ACT(Sum)/SAT _________________ Intended Area of Study_____________________________________________________________________ Academic Honors _________________________________________________________________________ ATHLETIC INFORMATION
Example: 1 2 3 4
Event(s) 400
Fr. So. Jr. 60.00 59.25 58.75
Sr. ???
Collegiate Goal 56.00
Height ______________ Weight (optional) _________ Years Participated _________________________ Other Athletic Interests _____________________________________________________________________ Serious Injuries? Is yes, describe _____________________________________________________________ _________________________________________________________________________________________ Other colleges you are considering __________________________________________________________ Have you registered for the NCAA Clearinghouse NO____ YES_____ PIN # ____________________ (If No...ask your Guidance Counselor) 650 W. Easterday Avenue • Sault Ste. Marie, MI 49783 Head Coach: Steve Eles 906-635-2765 • Fax 906-635-2753
NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES
BUSINESS REPLY MAIL FIRST-CLASS MAIL
PERMIT NO. 115
SAULT STE MARIE MI
POSTAGE WILL BE PAID BY ADDRESSEE
Track & Field / Cross Country Lake Superior State University 650 W Easterday Avenue Sault Ste Marie MI 49783
Attention: Juniors and Seniors
Track & Field Cross Country Lake Superior State University Track & Field / Cross Country Lake Superior State University 650 W. Easterday Avenue Sault Ste. Marie, MI 49783