College Track and Field
Prospective Student-Athlete Information Form

NOTE:This form is not an official college application.
This form will be used by the track and cross country staff to help determine prospective student-athletes.
Items marked with and asterisk* are required.

Personal Information

*Last Name *First Name Middle I.

*Home Phone # Cell Phone/Alternate Phone #

*E-mail Address

Country *Gender (m/f)

*Address 

*City    *State  *Zip 

Parent(s) / Guardian(s)

*Date of Birth (mo/day/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:

SAT: Date (mo/day/yr)  Verbal  Math 
ACT: Date (mo/day/yr)  Composite   

*High School Name  *Year of Graduation 

*Address 

*City  , *State  *Zip  *Phone 

Athletic Background
Events Time/Distance Date/Place *Coach's Name / Tel #
Other Sports *Position Varsity Letter 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


 
Bethany College
335 E. Swensson Street
Lindsborg, Kansas 67456-1897

Telephone: 1-785-227-3311 or 3380 x 8113
Admissions Fax: 1-785-227-8993
Admissions Telephone: 1-800-826-2281

 Copyright © 2006 Bethany College
Last Modified: January 10, 2007