Prospective Student-Athlete Questionnaire

* = Required Field
     Men's Basketball       Women's Basketball
     Men's Cross Country and Track       Women's Cross Country and Track
     Men's Golf       Women's Golf
     Men's Ice Hockey       Women's Tennis
     Men's Tennis       Women's Volleyball
        Women's Softball
* Full Name:
Date of Birth: (mm/dd/yyyy)
Home Address:
Home City:
Home State/Prov.:
Home Zip/PC:
Home Phone:
Cell Phone:
*Email Address:
NCAA Clearinghouse ID:
Father's Name:
Father's Occupation:
Mother's Name:
Mother's Occupation:
High School Coach:
High School Coach's Phone:
Travel Team Coach:
Travel Team Coach's Phone:
Travel Team/Club Team League:
Statistics/Honors from the Previous/Current Season:
Please List Other Sports You've Played:
Current Team's Website URL:

Scholastic Information

High School:
High School's Division/Class:
High School Principal:
High School Principal's Phone:
Guidance Counselor:
Guidance Counselor's Phone:
*Grade Point Average:
SAT (Verbal) Score:
SAT (Math) Score:
*ACT Score:
Class Rank:  (your rank/class size)
Date of Graduation:  (mm/dd/yyyy)
If you haven't taken the ACT or SAT,
when do you plan to?
College Degree/Interest:
Have you taken any college courses for credit?  Yes  No
If yes, please list courses:

Lake Superior State University. 650 W. Easterday Ave., Sault Ste. Marie, MI 49783
(906) 632-6841 or Admissions Toll Free at (888) 800-LSSU, Fax: (906) 635-2111