Prospective Student-Athlete

Women's Soccer Questionnaire

PERSONAL BACKGROUND

First Name: Last Name:
Graduation Date (mm/dd/yy): Email:
Name you go by: Place of Birth:
Area Code: Phone Number:
Street Address: City:
State: Zip:
Date of Birth (Month/Day/Year):
Father's Name: Mother's Name:
Father's Occupation: Mother's Occupation:
Does either of your parents work at Washington University? Yes No
Names & Ages of Siblings:
Do you have any relatives or friends at Washington U. (please list if yes):
Top Four College Choices: 1)   2)   3)   4)
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 Number:
GPA: /4.0  Scale: Class Rank: / SAT-CR: SAT-M: SAT-W:
ACT Composite: Math: English: Reading: Science: Writing:
Desired Course of Study:
Senior Class Schedule:
Academic Honors:

 

ATHLETIC BACKGROUND

Height: Weight: Preferred Position:
Other Positions: High School Coach: High School Phone Number:
40 Yard Time: Club Team: Club Coach:
100 Yard Time: Club Team Jersey No.: Club Coach Phone Number:
Vertical Jump: ODP Experience (level and years):
Please list any serious injuries or illnesses:
Goals Scored: FR:   SO:   JR:   SR:
Assists: FR:   SO:   JR:   SR:
Goals Against Average: FR:   SO:   JR:   SR:   Career Shutouts:   Career Save %:  
Do you have a video of your play available?: Yes    No
List Any Soccer Honors or Awards:

Thank you for your time and interest. If you have any other questions please contact:
Jim Conlon, Head Women's Soccer Coach
Washington University
Campus Box 1067, One Brookings Dr.
St. Louis, MO 63130
Phone: 314/935-4706
Fax: 314/935-5545
Email: jimconlon@wustl.edu