Introduction Section
This is the UConn Men's Track & Field and Cross Country Questionnaire.

Please be sure to enter all contact, academic and athletic information in full detail. Field event athletes; please note that the "Event" section is not just for track times, click "select event" and scroll down to find all field events listed.
Personal Information
First Name:
Last Name:
Preferred Name:
Country:
Street Address:
City:
State:
Zip:
Grad Year:
Date of Birth:
Email Address:
Home Phone:
Mobile Number:
FaceBook:
paste the URL from your Facebook profile
Parent(s) Information
Mother's First Name:
Mother's Last Name:
Mother's Address (If Different):
Mother's City:
Mother's State:
Mother's Zip:
Mother's Occupation:
Mother's Email Address:
Mother's Cell Phone:
Mother's Business Ph.:
Mother's College:
Living With:
Siblings (Names & Age):
Father's First Name:
Father's Last Name:
Father's Address (If Different):
Father's City:
Father's State:
Father's Zip:
Father's Occupation:
Father's Email Address:
Father's Cell Phone:
Father's Business Ph.:
Father's College:
Living With:
Guardian Information
Guardian's First Name:
Guardian's Last Name:
Gender:
Guardian's Occupation:
Guardian's Email Address:
Guardian's Cell Phone:
Living With:
Academic Information
School Name:
School Address:
School City:
School State:
School Zip:
School Phone#:
School Fax#:
Counselor's First Name:
Counselor's Last Name:
Counselor's Phone:
Counselor's Email:
GPA:
SAT Test Date:
SAT Reading:
SAT Math:
SAT Writing:
SAT Composite:
ACT Test Date:
ACT Composite:
TOEFL:
Class Rank:
Out Of
Intended Major:
Have you Joined the Eligibility Center?
Eligibility ID:
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
Other Questions
Coach's Name:
Coach's Email and Phone:
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: