University of Wisconsin - Eau Claire Athletics

Personal Information
First Name:
Last Name:
Address:
City, State, Zip:
Phone:
E-mail:
Father's Name:
Father's Occupation:
Mother's Name:
Mother's Occupation:

High School Information
High School:
High School Address:
City, State, Zip:
Coach's Name:
Coach's Phone:

Academic Information
Interested Area(s) of Study:
G.P.A.	out of Semesters
Class Rank:
Year of Graduation:
ACT Score:
SAT Score:
Academic Honors/Awards:
Interest in UW-Eau Claire?	Strong
	Average
	Slight
Other Schools Interested In:

Athletic Information
Athletic Events (Include Times/Marks):
Athletic Honors/Awards:
Other Sports Played

Copyright © UW-Eau Claire Athletic Department
ALL RIGHTS RESERVED
Tim Petermann
Department of Kinesiology and Athletics
Last Updated: