Cross Country and Track Questionnaire

Student Information

First Name

Preferred Name

Last Name

Birthdate

Email Address

For best email deliverability, we recommend not using a school email address.

Mobile Phone Number

May Cottey College contact you over SMS?

Mailing Address

Country

Street

City

Region

Postal Code

Parent/Guardian Information

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian Phone

Parent/Guardian Relationship Type

Do you want to provide information for a second parent/guardian?

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian Phone

Parent/Guardian Relationship Type

Academic Information

Anticipated Start Term

Student Type

Current School Name

Current School CEEB (Hidden)

Current School GPA

Program of Interest

Athletic Information

Athletic Interest (Ctrl+ to select both)

What events do you do?

Years at Varsity Level

What are your times/measurements?

Individual/Team Highlights

Upcoming Events

NAIA EC ID? (Go to play.naia.org)

Video Links

Additional Information

Clicking "Submit" below constitutes your written consent to be called/texted/emailed by Cottey College at the number(s)/address(s) you provided regarding furthering your education.

Hidden: Sport: Cross Country

Hidden: Sport: Track