Cheer Squad Questionnaire - Bethany College

Personal Information

*Last Name *First Name Middle I.

*Home/Cell Phone # *E-mail Address

Country Gender (m/f)

*Street Address

*City , *State *Zip

*Date of Birth (mo/day/yr) *Date of Grad (mo/yr)

*Height (ft/in) *Weight (lbs)

Ethnic Background (optional)

Non-Athletic Activities

Student Body Officer	Editor, School Publication	*Field of Study
Class President	National Honor Society	Other

Academic Information

*Class Rank *out of

*G.P.A.

Test Scores:

*High School/College Name *Year in School (fr/so/jr/sr)

*Address

*City , *State *Zip *Phone

Guidance Counselor

Athletic Background

*Years of cheer experience & type of team(s)	Number & type of different jumps preformed	*Tumbling skills, number of years, & indicate running or standing

*Stunt skills, number of years, & position	Co-ed experience	Varsity Letters & other sports

*Coach's Name/Tel #	Honors

Interest Level
Please select the level that represents your present interest in Bethany.

Other Colleges of Interest

Do you intend to apply for financial assistance to attend college (optional). Yes No