Name: Last, First, MI
Home Address
City/Town
State/Prov.
Zip:
Country
Mailing Address (if different than home address)
(Area Code) Home Phone Number
(Area Code) Cell Phone Number
Email Address
Date of Birth MM/DD/YY
Father / Guardian
Occupation
(W) Phone Number
(H) Phone Number
Mother / Guardian
High School
Country:
Phone:
Graduation Date (Month and Year)
Counselor:
Preferred Area of Study
Official Class Rank:
Out of:
GPA:
SAT Score::
Verbal:
Math:
Writing:
Date Taken
ACT Score
Verbal
Math
Reading
Science
Date Taken:
T.O.E.F.L. If first language is not English
List in order all other schools attended since high school
Months and years attended
FIS Number
Current FIS Sprint Points
Current FIS Distance Points
USSA Number
Current USAA Sprint Points
Current USAA Distance Points
Current USAA Overall Points
High School Coach:
E-mail:
Ski Club name (if applicable):
Club Coach:
Have you had any major injuries/illnesses within the last 3 years? If so, please describe:
Why do you wish to ski for a university?
Why are you interested in the University of Alaska Fairbanks?
Are you a runner? Yes No
If yes, what is your personal best time in a 10km?
What is your personal best time in a 5km?
Please give best five running results in last year: Race Name, Place, Distance, Time
Are you registered with the NCAA Clearinghouse? Yes No
If yes, please enter your Clearinghouse PIN
