Prospective Student-Athlete

Football Questionnaire

PERSONAL BACKGROUND

First Name: Last Name:
Name you go by: Email Address:
Phone Number: Number of Children in Family:
Street Address: City:
State: Zip:
Date of Birth (Month/Day/Year): Social Security #:
Ethnic Origin (optional):  
Father's Name: Mother's Name:
Father's Occupation: Mother's Occupation:
Does either of your parents work at Washington University? Yes No
College Attended: College Attended:
Living with Mother Father Both Other

ACADEMIC BACKGROUND (Please list Washington U. as one of the schools to receive your test scores.)

High School High School City:
High School State: High School Zip:
Coach's Name and Email Address: Home Phone:
Counselor's Name and Email Address: School Phone:
GPA: /4.0 Class Rank: / SAT-CR: SAT-M: SAT-W:
ACT Composite: Math: English: Reading: Science: Writing:
List the average grade you will receive (upon graduation) in these courses: Geometry: Trigonometry: Calculus: Physics:  Chemistry:
Honors or AP Classes: Date of Graduation:
Senior Class Schedule:
Academic Honors:
Academic Interests:

1)

2) 3)
Other Colleges You are Interested In:

1)

2) 3)
Friends or Relatives who Attended Washington :

ATHLETIC BACKGROUND

Height: Weight: Jersey Number: Light: Dark:
Position: Offense: Defense: Preferred:  
Specialties (punter, kicker, return, long snapper, etc.):
Years Started: Years Lettered: 40 Yard Time:
Athletic Honors:
List Other Varsity Sports Played: