Introduction Section
Dear Prospective Student-Athlete,

This email is to introduce you the University of Wisconsin as you begin the college selection process. Due to NCAA regulations our Wisconsin Badger Women’s Hockey program is unable to initiate written correspondence with you until June 15th of your sophomore year (grade 10).

For more information on our University and the hockey program, please visit our web site www.uwbadgers.com and www.wisc.edu or find us on Facebook as well on Twitter @BadgerWHockey.

In the meantime, we would appreciate it if you would fill out our questionnaire so that our coaching staff can learn more about your academic and athletic background.

We look forward to receiving your questionnaire.

GO Badgers!
Personal Information
First Name:
Last Name:
Preferred Name:
Country:
Address Type:
Street Address:
City:
State:
Zip:
Grad Year:
Date of Birth:
Email Address:
Home Phone:
Mobile Number:
What is your connection to this university:
Parent(s) Information
Parent 1's First Name:
Parent 1's Last Name:
Parent 1's Gender:
Parent 1's Address (If Different):
Parent 1's City:
Parent 1's State:
Parent 1's Zip:
Parent 1's Email Address:
Parent 1's Cell Phone:
Parent 1's Business Ph.:
Parent 1's College:
Living With:
Siblings (Names & Age):
Parent 2's First Name:
Parent 2's Last Name:
Parent 2's Gender:
Parent 2's Address (If Different):
Parent 2's City:
Parent 2's State:
Parent 2's Zip:
Parent 2's Email Address:
Parent 2's Cell Phone:
Parent 2's Business Ph.:
Parent 2's College:
Living With:
Most Influential People in Your Life: (1)
Most Influential People in Your Life: (2)
Academic Information
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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 Fax:
Counselor's Email:
GPA:
SAT Test Date:
SAT Composite:
ACT Composite:
Class Rank:
Out Of
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.)
Jersey #




Events
Positions
Hockey
Hockey
Shot
Shot
Other Questions
Colleges your interested In attending?:
When you have completed this questionnaire please click submit questionnaire.
School Name:
OR :
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:

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