La Salle - Recruiting

La Salle University Football Questionnaire

Personal Information
* Full Name:
Street Address:
City:	State: Zip:
* Phone:
** E-mail Address:
* Year of Graduation:
* Date of Birth:
* SSN #:
* Mother's Name:
* Mother's Occupation:
* Father's Name:
* Father's Occupation:	* Required ** Optional

Academic Information
High School:
Coach's Name:
H.S. Phone:
School Address:
Positon(s):	HT: WT:
Football Honors:
Other Sports Played:
NCAA Clearinghouse Registration Yes:	(Date):
Explorers Football
Grade Point Average:	Class Rank: Class Size:
Academic Honors:
HS Activities:
SAT Scores (V):	(M):
Date Taken:	Are you taking them again?
ACT Score:
Date Taken:	Are you taking them again?
College Major Interested In:
Have you applied for addmission to La Salle University?	Yes Date No:

Head Coach, Tim Miller (215) 951-1032 millert@lasalle.edu / Recruiting Coordinator, Terence Archer (215) 951-1557 archert@lasalle.edu