Rockhurst University Athletic Questionnaire  
Please fill in the information requested below and select submit.  
The fields in bold are required.  
 
First Name
Middle Initial
Last Name
Street Address
City
State or Province
State or Province (if Other)
Zip Code
Country
Home Phone Number
Cell Phone Number (if available)
Email
Date of Birth
Gender
Height
Weight
Father's Name
Mother's Name
 

High school or college currently attending
High school graduation year
Intended Major
ACT Score
SAT Total
G.P.A.
 

Sport
Position
Varsity Letters Earned
Team Awards / Achievements
Individual Awards / Achievements
Statistics
Coach's Name (high school/club/college)
Coach's Phone Number