Track & Field/Cross Country

There are errors with your form submission. Please review and submit again.

For interest student-athletes wanting to participate in cross country or track & field.

Personal Information

First Name

Last Name

Preferred Name

Date Of Birth

Email address *

Email Address (Verified)

Home Address 1

Home Address 2

City

State

Zip

Cell Phone Number

Home Phone Number

Can a track coach contact you?

Yes No

Academic Information

Graduation Year

High School Name

Address 1

Address 2

Address 3

City

State

Zip

GPA

ACT

SAT Total

Intended Major

Other College Choices

Academic Honors

Have you been to campus?

Yes No

If so, when?

High School Coach Name

High School Coach Phone Number

High School Coach Email

What Semester Will You Begin At Eureka?

Athletic Information

Event 1

Personal Record Event 1

Event 2

Personal Record Event 2

Event 3

Personal Record Event 3

Event 4

Personal Record Event 4

Honors/Awards

Other Sports Played

* required field