NavySports.com - Official Athletic Site for Navy Athletics

Navy Women's Lacrosse Questionnaire

Date Completed:
Personal Information
Name:
Nickname:
Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Social Security Number:
Email:
Birthdate:
Birthplace:
Father's Name:
Father's Occupation:
Father's Phone Number:
Father's College:
Mother's Name:
Mother's Occupation:
Mother's Phone Number:
Mother's College:
I live with (Mother,Father, Both, or Other):

Ethnic Background:
White/Caucasian	Black/African American	Hispanic	American Indian/Alaskan Native
Filipino	Asian/Pacific Islander	Other

Are you a U.S. Citizen?
Do you wear glasses or contacts?
Do you have asthma?
Medications Taking:
Are you color blind?:
Academic Information
High School/Prep School:
Address:
City, State:
County:
Zip:
Phone:
Academic Interest:
G.P.A,On Scale of:
Class Rank-Class Size:
PSAT Score V:	M: Date Taken:
SAT Score V:	M: Date Taken:
ACT Score V:	M: Date Taken:
Date of Graduation:

Upon graduation I expect to have completed the following courses (Yes or No):

ALGEBRA I:
ALGEBRA II:
GEOMETRY:
CALCULUS:
PRE CALCULUS:
TRIGONOMETRY:
PHYSICS:
CHEMISTRY:
Other math courses taken:
Lacrosse Information
Lacrosse Honors:
High School Coach's Name:
High School Coach's Phone Number:
High School Coach's E-mail:
Club Coach's Name:
Club Coach's Phone Number:
Club Coach's E-mail:
Summer Camps Attending Post Junior Year:
Height:
Weight:
40-Yard Dash Time:
Have you registered in the NCAA Clearinghouse?
Are you interested in the Naval Academy? (Very Much, Yes, or No):
Other colleges you are interested in:
Who will you look to for advice about colleges?
Do you have any relatives in the military? (Yes or No-You may be eligible for a Presidential Nomination)

Extracurricular Activities

Please list all non-athletic extracurricular activities in which you have participated:

Please list any Fall/Winter sports you participated (List positions, honors, and letters earned):

Do you know anyone that has graduated from the Naval Academy or is a current Midshipmen (If yes, who?):