TIFFIN UNIVERSITY
TRACK & CROSS COUNTRY

PERSONAL INFORMATION

FIRST NAME  
LAST NAME  
SSN  
DATE OF BIRTH  
GENDER  
ADDRESS  
 
CITY  
STATE  
ZIP  
HOME COUNTRY  
HOME PHONE  
CELL PHONE  
EMAIL  
MOTHER'S FIRST NAME  
MOTHER'S LAST NAME  
MOTHER'S EMAIL  
MOTHER'S CELL  
MOTHER'S OCCUPATION  
FATHER'S FIRST NAME  
FATHER'S LAST NAME  
FATHER'S EMAIL  
FATHER'S CELL  
FATHER'S OCCUPATION  
ARE YOU REGISTERED WITH THE NCAA CLEARINGHOUSE?  
CLEARINGHOUSE NO.  

ACADEMIC INFORMATION

HS NAME  

GRADUATION YEAR  
HS ADDRESS  
 
HS CITY  
HS STATE  
HS COUNTRY  
ZIP  
HS PHONE  
CLASS RANK/SIZE  
GRADE POINT AVERAGE/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  
EVENT GROUP  
HEIGHT  
WEIGHT  
BEST TIMES/DISTANCES  
TIME/DISTANCE EVENT

DATE
TIME/DISTANCE EVENT

DATE
TIME/DISTANCE EVENT

DATE
TIME/DISTANCE EVENT

DATE

TOP 3 XC TIMES (INCLUDE DISTANCE AND DATE)  
ATHLETIC HONORS  
OTHER SPORTS PLAYED  
SERIOUS INJURIES? IF YES, PLEASE DESCRIBE  
ATHLETIC LETTERS EARNED  
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.