Introduction Section
Block M Welcome to the University of Michigan Men’s Track and Field and Cross Country prospective student-athlete questionnaire.
Questionnaire Code
(not required):
Personal Information
First Name:
Middle Name:
Last Name:
Preferred Name:
Country:
Street Address:
City:
State:
Zip:
Grad Year:
Date of Birth:
Email Address:
Home Phone:
Mobile Number:
Skype:
Google Talk:
FaceBook:
paste the URL from your Facebook profile
Twitter:
@
enter your twitter username only
What is your connection to this university:
Parent(s) Information
Mother's First Name:
Mother's Last Name:
Mother's Occupation:
Mother's Email Address:
Mother's Cell Phone:
Mother's College:
Living With:
Siblings (Names & Age):
Father's First Name:
Father's Last Name:
Father's Occupation:
Father's Email Address:
Father's Cell Phone:
Father's College:
Living With:
Guardian Information
Guardian's First Name:
Guardian's Last Name:
Guardian's Address (If Different):
Guardian's City:
Guardian's State:
Guardian's Zip:
Gender:
Guardian's Occupation:
Guardian's Email Address:
Guardian's Cell Phone:
Guardian's Business Ph.:
Guardian's College:
Living With:
Academic Information
School Name:
School City:
School State:
School Zip:
School Phone#:
Counselor's First Name:
Counselor's Last Name:
Counselor's Phone:
Counselor's Fax:
Counselor's Email:
GPA:
SAT Test Date:
SAT Reading:
SAT Math:
SAT Writing:
SAT Composite:
ACT Test Date:
ACT Sum Score:
ACT Composite:
ACT English:
ACT Math:
ACT Reading:
ACT Science:
TOEFL:
Intended Major:
Have you Joined the Eligibility Center?
Eligibility ID:
Club Information
Club Name:
Club Address:
Club City:
Club State:
Club Zip:
Club Coach:
Club Coach Cell:
Club Coach Office:
Club Coach Home:
Club Coach Email:
Athletic Information
Height
Weight (in lbs.)
Events

Important: Once you select an event all fields for that event are required and must be input correctly. If all fields are not filled out correctly then those values will not be logged with your application.

Season Best 1 Best 1 Date Best 2 Best 2 Date
Event 1
Event 2
Event 3
Event 4
Event 5
Event 6
Positions
Sprints
Jumps
Throws
Distance
Other Questions
Best State Meet finish (event/place)::
Best National Meet finish (event/place)::
Other colleges you are considering::
Have you applied to FAFSA?:
High School coach's name, e-mail, and cell::
Other sports participated in::
When you have completed this questionnaire please click submit questionnaire.
School Name:
State:
City:


Club Name:
Team Name:
Coach Last Name:
State:
City:


Club Name:
Team Name:
Club State:
Club Coach First Name:
Club Coach Last Name:
Club Coach Email:
Club Coach Mobile: