Print this Questionnaire, Fill it Out, and Fax it to Wingate Football-704.233.8170

Wingate University Bulldogs

Football Questionnaire  

Personal Information

Name__________________________________________ Nickname______________________

Home Phone(_____)____________Cell Phone(_____)_____________E-Mail________________  

Address_______________________________________________________________________

Birthdate____/____/____ Social Security #_________________Place of Birth_______________  

Father’s Name________________________Father’s Occupation_________________________  

Father’s College____________ Father’s Employer____________Work Phone(___)__________  

Mother’s Name_________________________Mother’s Occupation_______________________  

Mother’s College____________Mother’s Employer____________Work Phone(___)__________  

Living with (Circle one): Mother / Father / Both / Other: Name:____________________Relationship____________  

Academic Information

High School or Junior College_____________________________________________________  

Address_______________________________________________________________________       

School Phone (____)_________________ Guidance Counselor___________________________  

Coach’s Name______________Work Phone (____)__________Home Phone (____)__________  

GPA_________ SAT-V__________SAT-M_________ACT_________Rank_______/________    

High School Graduation Date: Month________ Year_______

Potential College Major 1)_______________ 2)________________ 3)________________  

What Students, Graduates, or Friends of Wingate University do you know?______________________________________  

Other Colleges you are interested in: 1)_____________ 2)_____________ 3)_____________4)____________  

Athletic Information

Height__________ Weight__________ 40 yd._________ 100m_________200m_________  

Offensive Position__________ Defensive Position_________Jersey #____________  

Preferred College Position (List One):____________ Specialties__________________________  

Other Sports:_________________________Athletic Honors:____________________________  

Hobbies/ Interests:______________________________________________________________

Most influential people in your life: _________________________________________________

  I hereby authorize the release of my academic transcript to Wingate University.

_____________________________ Date____/_____/______