Dixie State College Athletics

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Athletics Recruiting Form

Recruiting Form

Sport: *
First Name *
Last Name *
Address *
City *
State *
Zip *
Date of Birth (MM/DD/YR) *
Email Address *
Phone *
ACADEMIC INFORMATION
Freshman/Transfer *
School Name (High School or College)
City, State, Zip
Graduation Date (Mo/Yr) *
GPA *
SAT/ACT Score *
Are you registered with the NCAA Clearing House? *	YesNo
Clearinghouse ID
FAMILY INFORMATION
Father's Name *
Occupation *
Attended College?	YesNo
Mother's Name
Occupation *
Attended College?	YesNo
Parents are:	MarriedDivorcedSeperated
Number of brother's and sisters?
Religous Affiliation (optional)
Annual Household Income (optional)	$0K-$45K$46K-$75K$76K-$125K$126K and over
Have you applied for FAFSA (Federal Financial Aid) @ FAFSA.ed.gov? *	YesNo
GENERAL INFORMATION
Have you completed a Dixie State application?	YesNo
Other Sports you compete in?
Personal bests/Honors in other Sports
ATHLETIC INFORMATION
Height
Weight
Position
Coach's Name
Home Phone
Work Phone
Summer Team
Coach's Name
Year's as a Starter (check all that Apply)	FreshmanSophomoreJuniorSenior
ADDITIONAL INFORMATION
Individual Atheltic Honors

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225 South 700 East, St George, UT
1-877-546-7327

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