Cross Country Team Application

High School Graduation Year*

Name*

First Last

Select Team*

Address*

Street Address City State ZIP Code

Cell Phone*

Date of Birth*

Email*

Height*

Weight*

Father's Name*

First Last

Father's Phone*

Mother's Name*

First Last

Mother's Phone*

High School*

High School Address*

Street Address City State ZIP Code

High School Phone*

Guidance Counselor Name*

First Last

Date of last Physical*

ACT Test Score*

Verbal Score*

Math Score*

Current GPA*

Class Ranking*

College Major Desired*

Have you registered with the NCAA Clearinghouse?*

What is your assigned Clearinghouse P.I.N. #?*

Years Run Cross Country*

Tournament Schedule/Finishes (Current Year Only)*