Please fill out the form below to submit your information to East Tennessee State Track & Field. All fields are not required but please keep in mind that the more information you supply the better your chances of being recruited.

Have you completed your sophomore year of high school?    Yes No

PERSONAL INFORMATION

Today’s Date
First Name
Last Name
Address 1
Address 2
City
State	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Europe Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming  Zip
Country
E-Mail
Home Phone
Social Security Number
Date of Birth
Age
Height
Weight

Are you registered with the NCAA Clearinghouse?

Yes No

FAMILY INFORMATION

Father
First Name
Last Name
Occupation
Work Phone
Home Phone
E-Mail

Mother
First Name
Last Name
Occupation
Work Phone
Home Phone
E-Mail
Number of Siblings

HIGH SCHOOL AND ACADEMIC INFORMATION

Graduation Date
High School Attended
H.S. Address 1
H.S. Address 2
H.S. City
H.S. State	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Europe Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming  Zip
H.S. Phone
Academic Counselor
Counselor Phone
Anticipated Area(s) of Study

TEST SCORES

G.P.A.		PSAT
SAT		ACT

COLLEGE/FOUR-YEAR COLLEGE BACKGROUND

Number of full time quarters/semesters attended
Total number of transferable units passed (if known)
GPA
Will you receive your A.A. degree?	Yes No
If yes, which term/year

CROSS COUNTRY INFORMATION

Best Time
XC Course
Year
Best Time Distance
XC Course
Year
Please List Athletic Achievements

HIGH SCHOOL COACH

First Name
Last Name
Phone
E-Mail

Please List Other Schools You Are Interested In
Why Are You Interested in East Tennessee State?