If you are interested in Concordia athletics and would like to contact a coach,
please fill out the following questionnaire.
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GENERAL INFORMATION |
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| 1. |
Full Name |
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Sex: |
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Male
Female
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| 3. |
Date of Birth |
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| 4. |
Age |
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| 5. |
Today's Date |
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| 6. |
Address |
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| 7. |
City, State, & Zip Code |
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E-mail Address |
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Cell Phone Number |
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| 10. |
Home Phone Number |
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I live with: |
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Mom
Dad
Both
Other
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Father's Name |
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| 13. |
Occupation |
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| 14. |
Mother's Name |
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| 15. |
Occupation |
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| 16. |
Have you visited Concordia's campus? If so, when? |
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| 17. |
Who do you know that attends, has attended, or is connected with Concordia? |
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| 18. |
What other schools you are considering? |
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| 19. |
Why are you interested in Concordia? |
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| 20. |
Comments |
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ACADEMIC
INFORMATION |
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| 21. |
Current School |
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| 22. |
City, State Zip (of school) |
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| 23. |
In what area of study do you plan to major? |
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| 24. |
School Phone |
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| 25. |
School Organizations and Honors |
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| 26. |
ACT Score |
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| 27. |
SAT Score |
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| 28. |
GPA |
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| 29. |
Class Rank |
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of
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| 30. |
Graduation Date |
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| 31. |
Current High School/College Coach and
Phone Number |
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ATHLETIC INFORMATION |
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| 32. |
Other sport you are interested
in participating in at CUNE . . .
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| 33. |
Height |
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| 34. |
Weight |
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| 35. |
Years of Experience |
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| 36. |
Check All That Apply |
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Club/Select
ODP
Regional
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| 37. |
Current Team You Play For Outside Your High School Team |
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| 38. |
Positions Played |
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| 39. |
Foot |
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Right
Left
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| 40. |
Any Stats To Share |
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Goals
Asst.
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| 41. |
Overall |
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Goals
Asst.
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| 42. |
Keepers |
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Saves
GAA
Shoutouts
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| 43. |
40 Yd Time |
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| 44. |
100 Yd Time |
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| 45. |
12 Minute Run (number of laps completed) |
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OTHER
ATHLETIC INFORMATION |
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| 46. |
Name other sports played,
your position(s), and any performance notes on the sport (honors, personal
bests, averages, etc.) |
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