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Athletic QuestionaireIf you are interested in competing in intercollegiate athletics at Virginia State University please complete the following form and submit it to the athletic department. This form is NOT an official university application. ATHLETICS INTEREST INFORMATION SHEET Name:_____________________________ Social Security #:__________________________ Date of Birth:_______________________ Address:__________________________________ City:______________________________ State/Zip:_________________________________ Home Phone:_______________________ Parents/Guardians:__________________________ School:____________________________ Address:__________________________________ City/State/Zip:_______________________ School Phone :___________________________ Coaches Name:______________________ Office Phone:______________________________ Graduation Date: ____________________ E-mail address: ____________________________ High School Rank: ___________________ Academic Area of Interest: __________________ Current Grade Point Avg.:______________ SAT/ACT Score:___________________________ Core Courses: Yes_____ No_____ Video Tape Available? Yes_______ No________ School Counselor: ___________________ Office Phone:______________________________ Height:________ Weight:_________ Sport(s) Participated In:_________________________ Sport(s) Interest: Please Circle Sport(s) Of Interest Women's: Basketball-Bowling-Softball-Tennis-Volleyball-Indoor/Outdoor Track & Field-Cross Country-Cheerleading-Golf Men's: Basketball-Baseball-Football-Indoor/Outdoor Track & Field-Tennis-Golf-Cross Country What other sport(s) would you like to see offered at VSU? _______________________ _________________________ __________________________ Have you submitted your Student Release Form to the NCAA Clearinghouse? Yes____ No____ Special Awards or Honors:________________________________________________________ ______________________________________________________________________________ |
