Yale Field Hockey Questionnaire

*denotes required field

Personal Information

Graduation Year*

First Name* Middle Name

Last Name* Preferred Name

Address* City*

State* ZIP* Country

Email*

Home Phone* Mobile Phone

Birth Date* Registered with Clearinghouse*

Clearinghouse ID #

Facebook Myspace

Family Information

Father's Name Father's Occupation

Father's Employer Father's Home Phone

Father's Work Phone Father's College

Mother's Name Mother's Occupation

Mother's Employer Mother's Home Phone

Mother's Work Phone Mother's College

I live with

The names and ages of my siblings are:

The best way to reach me is

Athletic Information

Position 1 Position 2

Height ft in Weight lbs

Jersey Number Other Sports

My Academic Interest are

My Online Video link is

High School Coach Name

Office Phone Cell Phone

Email

Scholastic Information

Country

School State

School

High School Counselor Phone

Class Rank GPA

SAT:	Date (mo/day/yr)	Critical Reading	Writing	Math
SAT II:
ACT:	Date (mo/day/yr)	Composite

Club Team

Club Team Name

Address

City State ZIP

Coach Name

Office Phone Cell Phone

Email

General Information

My Top Priorities in choosing a college are
1. 2. 3.

The students and alums I know are

My Favorite Hobbies are

The person who will help me choose a college is
Cell

The five schools I plan to visit are
1. 2. 3. 4. 5.