Athletic Prospect Questionnaire

WSC Admissions

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Wayne State College
1111 Main Street
Wayne, NE 68787
1-866-WSC-CATS (972-2287)
or 402-375-7234
e-mail: admit1@wsc.edu

Athletic Prospect Questionnaire

Cross Country

Full Name:

Email:

Phone:

Cell Phone:

Address:

City:

State:

Zip:

Date of Birth:

Social Security #:

Graduation Year:

Anticipated Major:

SPORT Related Information:

Your Events :

Event 1:

Event 2:

Event 3:

Event 4:

Best Mark:

Height: Weight:

Athletic Honors:

Other schools you are considering:

Parent Information:

Father's Name:

Address: (Include City, State, Zip)

Phone:

Occupation:

Mother's Name:

Address: (Include City, State, Zip)

Phone:

Occupation:

School Information:

Present School :

Address: (Include City, State, Zip)

Cross Country Coach:

Coach's Phone:

Track Coach:

Coach's Phone:

G.P.A.

Class Rank:

ACT/SAT Score:

Academic Honors

Junior College :

Freshman Sophomore

Division/Class

Jr College Grad Year

Have you registered with the NCAA Clearinghouse? Yes No

Have you applied for financial aid?
Yes: No:

Do you qualify for financial aid?
Yes: No:

Admissions Home

General Info: 800-228-9972 OR Admissions: 866-WSC-CATS

E-mail: webmaster@wsc.edu

Member, Nebraska State College System