Thank you for your interest in Crusader Football!

Please fill out our questionnaire as completely as possible, especially the required fields of First Name, Last Name, High School, Graduation Year, and E-mail address.

PLEASE ENTER ALL INFORMATION IN PROPER CASE, i.e. John Smith, not john smith; McCarthy, not Mccarthy!

Please use the TAB key to advance to the next field.

Click the SAVE button below when you're done. Be sure to read the comfirmation message that will appear.  You only need to submit the questionnaire once!

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Personal Information
Your Legal Name:
First Middle Last
Street Address:
State / Zip:
Family/Friends who attended or played at Valparaiso University:
Date of Birth:
Month Day Year
Email Address:
Home Phone:
Cell Phone:

Parent's Information
Mother's First Name:
Mother's Last Name:
Mother's Job:
Mother's Email:
Parents Marital Status:
Father's First Name:
Father's Last Name:
Father's Job:
Father's Email:
I Live With:
Number Of Siblings In College:

Academic Information
NOTICE: Please choose below, using the Select School button, the school you are CURRENTLY attending. If you are a Junior College student please pick or enter your JC info.
Please use the SELECT SCHOOL Button to select your current school. If not listed, click on UNLISTED SCHOOL to add it manually.
School Type:
School Name:
School Address:
School City:
School State / Zip:
School Phone #:
School Fax #:
Counselor First:
Counselor Last:
NOTICE: If you are a Junior College student please enter your Graduation information for your Junior College.
Graduation Year:
GPA (4.0 Scale): GPA (5.0 Scale):
GPA (12.0 Scale): GPA (Other Scale):
ACT Composite:
ACT Eng: Math:
ACT Reading: Science:
Writing Section Required For ACT
SAT Total: SAT CR:
If Entering SAT Score, Complete All Sections.
Class Rank:
Acad. Interest 1:
Acad. Interest 2:

Athletic Information
Coach's First Name:
Coach's Last Name:
Coach's Office #:
Coach's Home #:
Coach's Cell #:
Coach's Email:
List Other Schools That You Are Interested In Or Have Applied:
Athletic Honors/Awards:
NCAA Clearinghouse Number:
Offensive Position:
Defensive Position:
40 Time:
Jersey Number:
Jersey Color:
Link to Video:

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