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Recruiting Questionnaire

* = Required Field

Contact Information
* Name:      
First                         M.I.            Last
* Street: 
* City:   * State:  * Zip: 
*Home Phone:  () -   Cell Phone:  () -  
* Email: 

Education-Related Information
High School:
City:  State: 
Graduation Date:
Month:  Year: 
GPA:    Class Rank: 
Reading SAT:    Math SAT:     ACT: 
Status:
Tentative Major(s):
Other Colleges
Considering:

Athletic Information
Best Times As: 
50 Free:  100 Free: 
200 Free:  500 Free: 
1000 Free:  1650 Free: 
100 Back:  200 Back: 
100 Breast:  200 Breast: 
100 Fly:  200 Fly: 
200 IM:  400 IM: 
Awards/Honors:

Other Information
Parent Status:Married  Divorced  Other  
Father's Name: Occupation:
Mother's Name: Occupation:
Do you currently have a brother or sister enrolled in college?Yes  No  
If yes, please list the name of the school attended:
Will you be applying for need based financial aid?Yes  No  
Do you know anyone who is enrolled at Susquehanna presently or has attended Susquehanna? If so, list names:

 
Susquehanna University Last reviewed by Athletics Communications
Crusaders Athletics; James W. Garrett Sports Complex
©2004 Susquehanna University, Selinsgrove, PA 17870