BRYANT UNIVERSITY
1150 Douglas Pike, Smithfield, RI 02917-1284
Head Coach – Stephanie Reilly (401)232-6526 Fax # (401) 232-6076
Prospect Questionnaire

CROSS COUNTRY/TRACK &FIELD  

PERSONAL INFORMATION
Today’sDate:  (dd/mm/yyyy)
Last Name:
First Name:
Middle Name/Initial:
Prefix:
PreferredFirst Name:
Address:
City:
State: Zip Code:
Country: Nation:
Telephone: 
Gender:
Date of Birth: [yyyymmdd ex. June 5, 1990 = 19900605]
SocialSecurity:
E-MailAddress:
U.S. Citizen:
Race/Ethnicity:

ACADEMIC INFORMATION
High SchoolCode:
High School:
SchoolAddress:
City: State: Zip Code:
High SchoolGraduation Date(month & year):  (ex. June 2009)
TranscriptDate:
Class Rank of
Grade PointAverage:  
College TestScores:SAT: Verbal: Math: ACT : Date Taken:
Student Type:
Date ofcompletedapplication:
Height:
Weight:
Father: Father’sOccupation: College FatherAttended:
Mother: Mother’sOccupation:  College MotherAttended:  
Friends/Relativesattending/having attended Bryant (name,relationship, class):
Will you retake the SAT’s orthe ACT’s?:
Date:
GuidanceCounselor: Phone:
AcademicInterests/ IntendedMajor:

GENERAL INFORMATION
Will you apply to Bryant?
Do you plan toapply for financialaid?
List otherschools you areinterested in:
Other Varsitysports played:
Summer campsattended:

*** Please list performancesfor all years completedto date in your major events. Theseshould be meet times or distances only.
  Fr So Jr Sr   Fr So Jr Sr
55 Meter DiscusThrow
100 Meter Shot Put
200 Meter JavelinThrow
400 Meter Long Jump
800 Meter High Jump
1500/1600Meter TripleJump
3000/3200Meter HammerThrow
CrossCountry Wt. Throw
100 M.Hurdles 30”/33” PoleVault
300/400M. Hurdles Heptathlon/Pentathlon/Decathlon
Please send us a copy ofyour competitive schedule. Video tape:
Please listthe top threejuniors in your area (name, high school):