Welcome to the Trine University Cheer/Dance Questionnaire

I would love to learn more about your passion for cheer/dance.  Please fill out the following recruiting questionnaire to help me learn a little about your experience and background.  You can use the TAB key to advance to the next field and please don't forget to click the SAVE button when you're done to ensure I receive all your information.

Please be sure to fill out all required fields:
First Name, Last Name, Email, Select School, Graduation Year (e.g. 2016)

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Personal Information
 First  Middle  Last
Your Name:
Preferred Name:
Street Address:
State / Zip:
 Month  Day  Year
Date of Birth:
Email Address:
Home Phone:
Cell Phone:

Parent's Information
Mother's First Name:
Mother's Last Name:
Mother's Address:
Mother's City:
Mother's State / Zip:
Mother's Home Phone:
Mother's Cell:
Mother's Email:
Father's First Name:
Father's Last Name:
Father's Address:
Father's City:
Father's State / Zip:
Father's Home Phone:
Father's Cell:
Father's Email:

Emergency Contact Information
Contact First Name:
Contact Last Name:
Contact's Home Phone:
Contact's Cell:

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 #:
Graduation Year: GPA:
SAT Test Date:
SAT Score:
ACT Test Date:
ACT Score:
Intended Major:

HS Coach Info
Coach's First Name:
Coach's Last Name:
Coach's Email:
Coach's Office #:
Coach's Home #:
Coach's Cell #:

Competition Squad/Dance Studio
Name of Squad/Studio:
Coach's First Name:
Coach's Last Name:
Coach's Office #:
Coach's Home #:
Coach's Email:

Cheer/Dance Information
In Which Sport Are You Interested?
Complete the Questions Below for Cheerleading
Years of Cheerleading:
What Positions Have You Filled?
High Flier:
Mid Flier:
Do You Have Any Gymnastics Experience?
Running Tumbling:
Standing Tumbling:
Do You Have Medical Insurance?
Do You Have Any Medical Condition or Injury That Would Prohibit You From Participating in Conditioning Activities?
Complete the Questions Below for Dance
Years of Dance:
What Technique Do You Have?
Single Turn:
Double Turn:
Triple Turn and Above:
Leg Hold:
Tilt Kicks:
Left Turns:

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