1.	Date* mm/dd/yyyy

	Personal Information

2.	Gender*
	--Please Select--MaleFemale

3.	Last Name*

4.	First Name*

5.	Middle Initial*

6.	Street or P.O. Box*

7.	City*

8.	State*

9.	Zip*

10.	E-mail*

11.	Home Phone*

12.	Cell Phone

13.	Date of Birth* mm/dd/yyyy

14.	Height*

15.	Weight*

16.	Father's Name*

17.	Father's Occupation

18.	Mother's Name*

19.	Mother's Occupation

	Academics

20.	High School Name*

21.	HS City*

22.	HS State*

23.	Graduation Date* mm/yyyy

24.	Grade Point Average*
	Weighted   Unweighted

25.	SAT
	Math   Critical Reading   Writing

26.	ACT

27.	The UNCW Track and Field staff may request the release of my high school transcripts.*
	Agree  Disagree

28.	Intended Major / Academic Interest

	Athletics

29.	Name of High School Coach*

30.	Coach's Phone Number

31.	Performance
	PR   Date 100M     200M     400M     800M     1600M     3200M     5K XC     110H/100H     300H/400H     HJ     LJ     TJ     PV     SP     Discus     Hammer     Javelin

32.	Comments