Wittenberg University

Student-Athlete Recruiting Questionnaire

Athletics

Giving

Student Athlete Questionnaire

Track & Field

Personal Information:

First Name:*

Middle Name:

Last Name:*

Preferred Name:

Birthdate:* Month

Gender: Male Female

Are you:* a U.S Citizen/Permanent Resident an International

Citizenship:

Contact Information:

	Home Address:
Address Line1:*
Address Line2:
City:*
State:*
Zip:*
Country if outside U.S.
Home Phone:
Cell Phone:
Your E-mail:

Academic Information:

Areas of Academic Interest:

1) 2) 3)

Top 3 College Choices:

1) 2) 3)

G. P. A.
Class Rank: Class Size:

SAT (V):
SAT (M):
ACT (composite):

High School Information:

High School Name:

High School Phone:

Grad Year:

High School Coach:

High School Coach Phone:

High School Coach Email:

Father’s Name: Wittenberg alumnus? Yes No

Mother’s Name: Wittenberg alumnus? Yes No

Wittenberg students/alumni that you know:

Financial Information:

Do you plan to apply for financial aid?

Financial aid applicants must complete the Free Application for Federal Student Aid (FAFSA). A Financial Assistance Estimator is also available through the Office of Admission.

Has the FAFSA been completed? Wittenberg's FAFSA code is: 003143

Please send: Viewbook Application Financial Aid Information

Cross Country and/or Track Experience/Player Profile

Events Competed in with:

Times:	Height:	Distance:

Times:	Height:	Distance:

Times:	Height:	Distance:

Times:	Height:	Distance:

Times:	Height:	Distance:

Times:	Height:	Distance:

Times:	Height:	Distance:

Best performance results

Years competing in:

Cross Country:	Track:	Other (specify):

Wittenberg Cross Country and/or Track: Please list any questions about our Cross Country and/or Track Program.

Campus Visitation

Have you visited the Wittenberg campus?

Yes	No	If so, When?

Do you plan to visit Wittenberg in the near future?

Yes	No	If so, When?

Would you like to meet with the track coach during your campus visit?

Yes	No

Thank you for filling out this questionnaire and helping us to learn more about you!

Post Office Box 720
Springfield, Ohio 45501
Ph: 800-677-7558

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First Name:*
Middle Name:
Last Name:*
Preferred Name:
Birthdate:*	Month
Gender:	Male Female
Are you:*	a U.S Citizen/Permanent Resident an International
Citizenship:

G. P. A.	Class Rank:	Class Size:
SAT (V):	SAT (M):	ACT (composite):

High School Name:
High School Phone:
Grad Year:
High School Coach:
High School Coach Phone:
High School Coach Email:
Father’s Name:	Wittenberg alumnus?	Yes No
Mother’s Name:	Wittenberg alumnus?	Yes No