Cheerleading/Dance Recruiting Questionnaire

Email Secondary Email

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Email address *

First name *

Last name *

Address 1

Address 2

City

State

ZIP Code

Cell Phone Number

Please select which you are interested in? *

Cheer Dance

Height

Weight

Date of Birth

Father's Name

Father's Email

Father's Occupation

Mother's Name

Mother's Email

Mother's Occupation

Would you like to visit the campus?

Yes No Already Visited

Scholastic Information

High School

School Phone

Graduation Year

GPA

Class Rank

ACT

SAT

Intended Major

College Name

GPA

Hours Passed

Years of Eligibility Left

Name of High School Coach

Coach's Phone #

Athletic and/or Academic Honors/Awards

Questions/Comments

Are game/match tapes available?:

Yes No

* required field