Women's Cross Country Recruiting Questionnaire

Women's Cross Country

Please complete the following form with all available information. Hit the SUBMIT button at the bottom to electronically submit. If submitting an application by mail, please type or print all answers and mail to address listed at the bottom.

Indicates a Required Field

Last Name:
First Name:
Middle Initial:
Email Address:
Date of Birth:
Phone Number:
Street Address:
City:
State:
Zip:
Country:
Time: 1500/1600:
Time: 3000/3200:
Time: 5K:
Time: 10K:
State Meet Qualifications (years & events):
Years Participated in track and events ran:
Years participated in Cross Country:
Most recent cross country season (year):
Coach:
Coach's Phone Number:
Coach's Email Address:
Athletic Honors Received:
Other Athletic Interests:
Name of your high school:
High school street address:
High school city:
High school state:
High school zip:
Cumulative Grade Point:
Class rank:
ACT Score (if available):
Academic Honors Received:
Graduation Date and Year:
Academic Interest Area(s):
Name / Signature:
Date:
Verification Code:

You may choose to submit this application electronically, or by mail, to:

Molly Struve, Cross Country Coach
300 South 18th Street
Estherville, IA 51334-2725

Iowa Lakes Community College
Campuses in Algona, Emmetsburg,
Estherville, Spencer and Spirit Lake.

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