locl Loyola University Maryland Official Athletic Site - Athletics

CROSS COUNTRY AND TRACK RECRUIT FORM
PERSONAL INFORMATION

FIRST NAME

LAST NAME

FEMALE OR MALE?

Female
Male

ADDRESS

CITY

STATE

ZIP

HOME COUNTRY

HOME PHONE

CELL PHONE

EMAIL

DATE OF BIRTH

MOTHER'S FIRST NAME

MOTHER'S LAST NAME

MOTHER'S EMAIL

MOTHER'S WORK PHONE

MOTHER'S CELL

MOTHER'S ALMA MATER

MOTHER'S OCCUPATION

FATHER'S FIRST NAME

FATHER'S LAST NAME

FATHER'S EMAIL

FATHER'S WORK PHONE

FATHER'S CELL

FATHER'S ALMA MATER

FATHER'S OCCUPATION

BROTHERS/SISTERS: NAME/AGE

OTHER SCHOOLS INTERESTED

REGISTERED WITH NCAA CLEARINGHOUSE?

Yes.
No.

NCAA CLEARINGHOUSE #

ARE ANY FAMILY MEMBERS LOYOLA ALUMNI?

Yes.
No.

ACADEMIC INFORMATION HS NAME

GRADUATION YEAR

HS ADDRESS

HS CITY

HS STATE

ZIP

HS PHONE

CLASS RANK

GRADE POINT AVERAGE

ACT

SAT TOTAL

SAT CRITICAL READING

SAT WRITING

SAT MATH

INTENDED MAJOR

ATHLETIC INFORMATION

HS COACH'S FIRST NAME

HS COACH'S LAST NAME

HS COACH'S EMAIL

HS COACH'S CELL PHONE

HS COACH'S WORK PHONE

HEIGHT

WEIGHT

THREE EVENTS PARTICIPATED IN/FINISH

Event #1
Finish #1
Event #2
Finish #2
Event #3
Finish #3

OTHER SPORTS PLAYED

CLUB TEAM

CLUB COACH'S FIRST NAME

CLUB COACH'S LAST NAME

CLUB COACH'S EMAIL

CLUB COACH'S CELL PHONE

PLEASE CERTIFY THAT YOU ARE A HIGH SCHOOL JUNIOR OR SENIOR, OR ARE A CURRENT COLLEGE STUDENT
Yes, I am either a junior or senior, or a current college student.
No, I am younger than a junior.