SALEM INTERNATIONAL UNIVERSITY – Cross Country
Please Complete and Return to:
Carl Hatfield - Men’s & Women’s Cross Country Coach
Salem International University
223 West Main St.
Salem, WV 26426
Recruiting Questionnaire
Name:______________________________________________________________________
Last First Middle
Mailing Address:________________________________________________________________
City:________________State/Prov.:____________Country:_________Postal Code:__________
Telephone:( )________________Email Address:__________________________________
High School:________________________________ Graduation Date:_____________________
High School Address:_____________________________________________________________
Junior College/College or University:______________________________ Semesters:_________
SSN___________________ D.O.B.___________ GPA___________ Class Rank_______________
SAT Scores: Verbal________ Math_________
ACT Scores: Eng.:______ Math:________ Reading________ Science_________ Comp:________
Are you registered with the NCAA Initial Eligibility Center (Clearinghouse)? (Y/N) ____________
Intended College Major:__________________________________________
Anticipated Start Date:____________________________________
Other Colleges that you are applying to:_____________________________________________
Parents/Guardians Names and Occupations:__________________________________________
__________________________________________
Number of Siblings (ages)_________________________________________________________
Cross Country Specific Information:
Ht:______ WT:_________
High School Cross Country Coach:______________________ Phone #____________________
Track / Running Club Coach:___________________________ Phone #____________________
How many years running? ______________________
Distance Performances
800 Meters __________
1600 Meters __________
3200 Meters __________
5K X-C ___________
OTHER ____________
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