Women's Crew - Questionnaire

Men's Crew Questionnaire

Personal Information
Name:
Address:
City:
State:
Zip Code:
Country:
Home Phone:
Cell Phone:
E-mail Address:
Date of Birth:
Social Security #:	(Required for official visit)
Height:	Weight:

Academic Information
High School:
Graduation Date:
Possible Area of Study:
SAT Scores: M W CR Date Taken:
ACT (composite): Date Taken:
TOEFL: Date Taken:
Will you be applying for financial aid? Yes No

Athletic Information
Rowing Program:	Scholastic Club
Position: PORT STBD COX
Coach:
Coach's Phone:
Coach's E-mail:
Erg Scores: 2K: Date: 4K: Date: 6K: Date:
I train with my team... In the Spring only In the Fall and Spring Through the school year For how long?
Race Results:
Regatta: Year: Event: Seat #: Result:
Regatta: Year: Event: Seat #: Result:
Regatta: Year: Event: Seat #: Result:
Regatta: Year: Event: Seat #: Result:
Regatta: Year: Event: Seat #: Result:
Other Sports Played:
Other Athletic Achievements: Enter any questions or comments here:

Once you have completed this form, please fax, e-mail or mail a copy of your current transripts and test score reports using the information listed below.

Mailing Address:
John Pojednic - Men's Crew
Dept. of Athletics
219 Cabot Gym
Northeastern University
Boston, MA 02115

E-mail Address: j.pojednic@neu.edu
Fax: (617) 373-8988
Phone: (617) 373-8841