Track & Field Information Form

Directions: Please fill out all sections of this information sheet. Click the send button at the bottom of the page. You will then be shown a copy of what you have sent. Hit the back button on your browser to return to this page. Your information will be forwarded to Head Coach Ben Welch and to EOU's Admissions/New Students Program.

Personal Information

First Name Last Name
Address
City State Zip
Phone
E-Mail
Age Date of Birth Year of Graduation

Personal Information

Parent(s) Name(s)
 Address
City
State
Zip


Other Parent(s) Name(s)
 Address
City
State
Zip


Academics

SAT Scores (optional):
Math Verbal ACT
Class Rank of GPA
Desired Field(s) of Study

School

High School Coach's Name Coach's Phone
Junior College Coach's Name Coach's Phone
4 yr. College Coach's Name Coach's Phone

Track and Field Information

Years of varsity participation
EventTimes/DistancesDate

Cross Country Information

Years of varsity participation Letters won
Rank on team: of Best time Distance

Other Information

Please list any athletic honors:

Which of the following to plan to participate in at Eastern Oregon?

Cross Country Indoor Track Outdoor Track
Other (please indicate)

Have you had an interview? Yes No Have you visited campus? Yes No