NSU Track & Field

Contact Information
Name: (Last, First MI)     ie. Doe, John C  
Mailing Address:            
City:                               
State:                              
Zip:                                
Home Phone:                  ie. 123-333-5555  
Cell Phone:                     ie. 123-333-5555  
Email Address:               
High School & Coach Information
Coaches Name:                 ie. Doe, John  
High School:                   
High School Address:       
City:                               
State:                             
Zip:                                
Physical Information
Height:   
Weight: lbs.                   
Track Events - Personal Bests  Open Times Preferred - Relay Times Are Acceptable  
   100m                         200m                  400m       
   800m                1600m        3200m   
   100/110m Hurdles     300m Hurdles      
Field Events - Personal Bests   
  Long Jump Triple Jump                
  High Jump  Pole Vault   
  Shot Put      Discus           Javelin         
School & Coach Information                    
Birthdate:                             
Current Year in School:        
Graduation Month & Year:  -  
Academic Interests:              
GPA:   Class Rank: (ie. 13/76)   ACT:   SAT:   
Any other information you would like to provide:                    
 
Miscellaneous Information
Registered with NCAA Clearinghouse?   www.ncaaclearinghouse.net  
Interest in Northern State University  (5=Very Interested)