UMES TRACK AND FIELD & CROSS COUNTRY QUESTIONAIRE

NAME (LAST, FIRST)

STREET ADDRESS

CITY

STATE

ZIP

EMAIL ADDRESS

HOME PHONE NUMBER

CELL PHONE NUMBER

BEST TIME TO CALL YOU

BIRTH DATE

HEIGHT

WEIGHT

HIGH SCHOOL

COACH'S NAME

COACH'S PHONE NUMBER

PLEASE LIST YOUR THREE BEST PERFORMANCES BELOW

EVENT
TIME/DIST
EVENT
TIME/DIST
EVENT
TIME/DIST

REGISTERED WITH NCAA ELIGIBILITY CENTER?
Yes No