Eureka College New Student Packet 2013-14

Full Name ____________________________________________________________________________ Last First Year of Athletic Eligibility (please check) Middle Fr. So. Jr. Name you prefer Sr. Today’s Date ___________________ Your Sport(s)___________________________________________________________________________ Date of Birth _____ / _____ / _____ City of Birth ____________________________________________ Hometown ____________________________________________________________________________ High School Attended, Location, Year of Graduation, Mascot _______________________________________ _____________________________________________________________________________________ list any Previous Colleges Attended, Location, Mascot (COMPLETE ONLY IF PARTICIPATING IN ATHLETICS) ______________________________________________________________________________________ ______________________________________________________________________________________ Height ___________ Weight ____________ Academic Major ____________________________________ Father’s name ____________________________ Mother’s Name __________________________________ Siblings (Age) ___________________________________________________________________________ In any media guides or the website, how do you want your parents listed? (i.e.: “son/daughter of...”): ______________________________________________________________________________________ Individual or team accomplishments from high school (All-conference honors, conference or regional championships, won-loss records, personal statistics, etc.) PLEASE BE SPECIFIC! DO NOT LEAVE THIS AREA BLANK! ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ sportsinformationquestionnaire EUREKA COLLEGE SPORTS INFORMATION QUESTIONNAIRE ______________________________________________________________________________________ Academic Honors (High School or Collegiate) ___________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ This form must be returned to: Bryan Moore, Sports Information Director, Reagan Center Room 204, 300 E. College Avenue, Eureka, IL 61530-1500 23

Eureka College New Student Packet 2013-14 | Page 23