MSU-Northern Athletics: Lights Wrestling

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Prospective Wrestling Questionnaire

We would appreciate you supplying us with the following information which will be added to your file.

Personal Information
First Name*
Middle Name
Last Name*
Email Address*
Home Phone*
Best time to reach you
Street Address
City
State/Province/Region
Zip

Father's Name
Father's Occupation
Mother's Name
Mother's Occupation

Wrestling Weight
Normal Weight
Height
Date of Birth
High School/Collegiate Information
High School
Core GPA
Class in School	FR SO JR SR
ACT Score
SAT Score
Honors
HS Coach Name
HS Coach Phone #
Intended College Major
Wrestling Information
HS Record & State Placing	FR: SO: JR: SR:
HS Wrestling Honors

College Record (Transfer Stdudents)
College Wrestling Honors
Additional Information
Additional Comments & Questions

* - Required fields

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Montana State University-Northern Athletic Department (406) 265-3761 (Phone) \| (406) 265-4129 (Fax) Contact Us www.msun.edu/athletics	Copyright © 2005-2006 Updated: 09/05/2006	Armory Gymnasium Montana State University-Northern P.O. Box 7751 1 College Drive Havre, MT 59501-7751