Cross Country Questionnaire

Your E-mail Address	*
Full Name	*
Age
Height
Weight
Shoe Size
Date of Birth
Home Address	*
City	*
State	*
Zip Code	*
Home Phone Number (Area Code + Number)	*
Father's Last Name
Father's First Name
Mother's Last Name
Mother's First Name
High School
High School Address
High School Phone Number (Area Code + Number)
High School Coach
High School Coach Phone Number
High School Graduation Date
High School GPA
High School Class Rank
High School Class Size
SAT or ACT Score
College Major
Cross Country Event Specialty
Best Time
Athletic Honors or Awards

Alderson-Broaddus College • 101 College Hill Drive • Philippi, WV • 26416
Switchboard - 304-457-1700 • Admissions - 1-800-263-1549