La Salle - Recruiting

Prospective Student-Athlete Questionnaire

Personal Information

*First Name:
*Last Name:
Address:
City:
State:
Zip:
*Home Phone:
Cell Phone:
**E-Mail:	* Required ** Optional
Academic Information
High School:
Grad Year:	GPA: SAT:
School Address:
City:
State:
Zip:
Athletic Information
Club Team:
Who is Your Coach:
Date of Birth:
Height:	Weight:
Erg Score:

Tell us about yourself. (eg. event statistical information, scores):