Name:

Address:

              

City:

State:  Zip Code 

Country: 

E-Mail Address:

Home Phone Number:

Cell Phone Number:

Academic Information

GPA: out of

SAT Score: Date Taken:

ACT Score: Date Taken:
Have you applied to Wesleyan:
Registered with NCAA Clearing House:
File a FAFSA?:
Intended Major:
 

Athletic Information

High School: 

Address

High School Coach: 

Coach Phone Number:  

 

Height: Weight:

Event: Best Time:

Event: Best Time:

Event: Best Time:

Club Team:
Club Team Coach: Phone: 

Junior National Qualifier: 
Senior National Qualifier: