LOYOLA UNIVERSITY CHICAGO
TRACK & CROSS COUNTRY

PERSONAL INFORMATION

FIRST NAME  
LAST NAME  
GENDER  
ADDRESS  
 
CITY  
STATE  
ZIP  
HOME COUNTRY  
HOME PHONE  
CELL PHONE  
EMAIL  
DATE OF BIRTH  
MOTHER/GUARDIAN FIRST NAME  
MOTHER/GUARDIAN LAST NAME  
MOTHER/GUARDIAN EMAIL  
MOTHER/GUARDIAN WORK PHONE  
MOTHER/GUARDIAN CELL  
MOTHER/GUARDIAN ALMA MATER  
MOTHER/GUARDIAN OCCUPATION  
FATHER/GUARDIAN FIRST NAME  
FATHER/GUARDIAN LAST NAME  
FATHER/GUARDIAN EMAIL  
FATHER/GUARDIAN WORK PHONE  
FATHER/GUARDIAN CELL  
FATHER/GUARDIAN ALMA MATER  
FATHER/GUARDIAN OCCUPATION  
SIBLINGS  
OTHER SCHOOLS INTERESTED  
ARE YOU REGISTERED WITH THE ELIGIBILITY CENTER?  
IF YES, WHAT IS YOUR ELIGIBILITY CENTER ID?  

ACADEMIC INFORMATION

HS NAME  

GRADUATION YEAR  
HS ADDRESS  
 
HS CITY  
HS STATE  
ZIP  
HS PHONE  
CLASS RANK  
GPA/SCALE  
ACT  
SAT TOTAL  
INTENDED MAJOR  

ATHLETIC INFORMATION

HS COACH'S FIRST NAME  
HS COACH'S LAST NAME  
HS COACH'S EMAIL  
HS COACH'S CELL PHONE  
HS COACH'S WORK PHONE  
HEIGHT  
WEIGHT  
ATHLETIC HONORS  
OTHER SPORTS PLAYED  
 

In order to select more than one value, hold down CTRL on a PC or the command/apple key on a Mac

EVENTS  
EVENT TIMES/DISTANCES  
TIME/DISTANCE EVENT

DATE
TIME/DISTANCE EVENT

DATE
TIME/DISTANCE EVENT

DATE
TIME/DISTANCE EVENT

DATE

PLEASE CERTIFY THAT YOU ARE A HIGH SCHOOL JUNIOR OR SENIOR, OR ARE A CURRENT COLLEGE STUDENT   Yes, it is AFTER September 1st of my Junior year of high school.
No, it is BEFORE September 1st of my Junior year of high school.