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Questionnaire for Prospective Athletes

Personal Information
Full Name:
Home Address:
City:
State:
Zip Code:
Home Phone:
Email Address:
Birth Date:mm/dd/yyyy
Year of HS Graduation:

Parent / Guardian Information
Father's Name:
Father's Occupation:
Mother's Name:
Mother's Occupation:

High School Information
High School:
HS Grade Point Average:
SAT/ACT Score(s):   


Athletic Information
Head Coach:
Primary Events & Personal Bests:
Goal(s) for :
Other Sports of Participation:
HS Coach's email address:

Various Information
Course(s) if Study Interested:
Anything you would like to add?

Contact Information

Head Coach: Matt Hart
Office Phone: (503)491-7455
Fax: (503) 491-7397
Email Address: hartm@mhcc.edu
Web Site: www.mhcc.edu

PLEASE EITHER PRINT AND SEND THE COMPLETED QUESTIONAIRE TO :
Mt. Hood Community College
Cross Country
Track & Field
26000 SE Stark St
Gresham Oregon 97030

OR

CLICK THE SUBMIT BUTTON and it will be sent directly to Coach Hart's Email

 

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