Prospective Cross Country Athlete's Questionnaire

Fill out the following information and it will be sent directly to Coach Einbecker.

You can then fill out an online application or browse the Missouri Valley College website.

Personal

Name
Age
Birthdate
Home Address
City
State
Zip
Phone Number
Cell Phone
Height Weight
Email Address
*required
Father's Name
Father's Phone Number
Mother's Name
Mother's Phone Number

Academic

High School
GPA
Date of Graduation
Guidance Counselor
Counselor's Phone Number
Class Rank        out of   
Academic Test Taken (ACT/SAT) Score
Academic Area of Interest

For Transfer Students Only

School
Phone Number
School Address
Will you graduate? Yes No
Date of Graduation
Hours Completed
GPA

General Athletic Information

Other high school sports you paticipated in
Team Accomplishments
Individual Honors, Awards, etc.

Event(s)
Event 1 Time 1
Event 2 Time 2
Event 3 Time 3
 
Honors
Coach's Name
Phone
Free Period