Welcome to Southern Illinois University Football
Prospective Student Athlete Questionnaire

Please fill out the following questionnaire.  DO NOT FILL OUT THE QUESTIONNAIRE MORE THAN ONCE.

 
Click the SAVE button below when you're done.
Please use the TAB key to advance to the next field.
This site uses pop-ups.
Please turn off your pop-up blocking software before continuing.
If using Internet Explorer: Click on Tools, Pop-up Blocker, and Turn off pop-up blocker.

Please be sure to fill out all required fields:
First Name, Last Name, Select School, H.S. Grad Year (e.g. 2014)

 

Coach's Submit Tab: Players Please Move To Next Tab Below
 
Player Name:
First Last
Street Address:
City:
State / Zip:
Cell Phone:
Graduation Year:
Email Address:
Offensive Position:
Defensive Position:
Specialties:
Please use the SELECT SCHOOL Button to choose your school.
School Type:
School Name:
School Address:
School City:
School State / Zip:


 

Personal Information
 
Your Name:
First Middle Last
Nickname:
Street Address:
City:
State / Zip:
Please list students or alumni that you know:
Date of Birth:
Month Day Year
Email Address:
Home Phone:
Cell Phone:
Fax:
Church Affiliation:
 

Parent's Information
 
Mother's First Name:
Mother's Last Name:
Mother's Job:
Mother's Work #:
Mother's Home #:
Mother's Address:
City:
State / Zip:
Mother's College:
I Live With:
If Other, Name:
Father's First Name:
Father's Last Name:
Father's Job:
Father's Work #:
Father's Home #:
Father's Address:
City:
State / Zip:
Father's College:
Parents Are:
Brothers/Sisters-Names/Ages:
 

Academic Information
 
Please use the SELECT SCHOOL Button to choose your school.
School Type:
School Name:
School Address:
School City:
School State / Zip:
School Phone #:
School Fax #:
Counselor's First Name:
Counselor's Last Name:
Counselor's Phone:
Year:
GPA: Core GPA:
PSAT:
SAT Test Date: Score:
ACT Test Date: Score:
Class Rank:
Planned College Course of Study:
 

Athletic Information
 
Coach's First Name:
Coach's Last Name:
Coach's Office #:
Coach's Home #:
Coach's Cell #:
Coach's College:
Top Three College Choices:
Who Will Help You Make Your College Choice?
Height:
Weight:
Offensive Position:
Defensive Position:
Specialty:
Preferred Position:
40 Time:
100 Time:
Jersey Number:
Other Varsity Sports:
Who Is The Most Influential Person In Your Life?
 

When you have completed this questionnaire please click the save button.