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  Home > Athletics > ATHLETIC QUESTIONNAIRE  

If you are interested in participating in a varsity sport at Dana College, please fill out the following biographical questionnaire. Once submitted, this form will be automatically emailed to our Admissions Office. A member of the coaching staff will contact you at his or her earliest convenience.

Sport:  

First Name:  Middle Initial: Last Name: 

Mailing Address:  

City:   State:   Zip: 

Home Phone: (xxx-xxx-xxxx)

My Cell Phone: (xxx-xxx-xxxx)

Email:

Social Security Number:

Height: Weight:

Date of Birth: (mm/dd/yyyy)

Mother's Name:

Father's Name:

Semester I plan to enroll:  

Proposed area(s) of study:

ACT Composite: SAT Score: Verbal: Math:

I will enter Dana as a: Freshman  Transfer

High School or Junior College:

School Address:

City: State: Zip:

School Phone: (xxx-xxx-xxxx) Anticipated Graduation Date:

High School or Junior College Coach:

Coach's Home Phone: (xxx-xxx-xxxx)

Guidance Counselor:

GPA: Class Rank: 

Academic Honors:

Do you have a videotape available for the coach's viewing? Yes  No

If applicable, what position do you play?

General Athletic Information: Please list any information pertinent to your sport, i.e. club teams you play for, statistics, 40-yard dash time, awards/honors, left-handed or right-handed, etc.