Introduction Section
Questionnaire Code
(not required):
Personal Information
First Name:
Middle Name:
Last Name:
Preferred Name:
Country:
Address Type:
Street Address:
City:
State:
Zip:
Grad Year:
Date of Birth:
Email Address:
Home Phone:
Mobile Number:
Skype:
FaceBook:
Twitter:
@
Instagram:
@
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 Occupation:
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 Occupation:
Parent 2's Email Address:
Parent 2's Cell Phone:
Parent 2's Business Ph.:
Parent 2's College:
Living With:
Academic Information
{{item.text}} No schools matching "{{sd.searchText}}" were found.
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 Reading:
SAT Math:
SAT Writing:
SAT Composite:
ACT Test Date:
ACT Sum Score:
ACT Composite:
ACT English:
ACT Math:
ACT Reading:
ACT Science:
TOEFL:
Class Rank:
Out Of
Intended Major:
Have you Joined the Eligibility Center?
Eligibility ID:
Athletic Information
Height
Weight (in lbs.)
Jersey #
Events
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
Verticle Jumps
Verticle Jumps
Sprints
Sprints
Hurdles
Hurdles
Horizontal Jumps
Horizontal Jumps
Mid-Distance
Mid-Distance
Distance
Distance
Throws
Throws
Multi-Event
Multi-Event
Other Questions
Why Xavier:
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:

Do you still want to add the prospect?