Introduction Section
Thank you for your interest in Southeast Missouri State University and our Men's/Women's Track and Field program. By filling out this questionnaire completely, you will not only help our coaching staff contact you regarding participation in Men's/Women's Track and Field, but also enable our admissions staff to begin the process of reviewing your academic information regarding your attendance at Southeast Missouri State University.

Choosing a college is a tremendous journey in a student-athlete's life. We at Southeast Missouri State University are honored that you have chosen to include us in your search.

We look forward to speaking with you further!


Eric Crumpecker
Head Track and Field Coach
Questionnaire Code
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Personal Information
First Name:
Last Name:
Country:
Street Address:
City:
State:
Zip:
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Date of Birth:
Email Address:
Home Phone:
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What is your connection to this university:
Parent(s) Information
Mother's First Name:
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Father's First Name:
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Father's Cell Phone:
Guardian Information
Guardian's First Name:
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Gender:
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Academic Information
School Name:
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School Zip:
School Phone#:
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GPA:
SAT Test Date:
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ACT Test Date:
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ACT Composite:
ACT English:
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TOEFL:
Have you Joined the Eligibility Center?
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Club Information
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Club Coach:
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Athletic Information
Height
Weight (in lbs.)
Jersey #


Positions
Other Questions
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: