WESLEYAN HOCKEY QUESTIONNAIRE
Last Name: First Name: MI
Home Address:
City, State Zip:
Home Phone Number: Cell Phone Number:
Email Address: Date of Birth:
Parents/Guardians:
Secondary School: Graduation Year:
SAT Scores: CR: Math: Writing: ACT Composite:
GPA: Class Rank:
Area(s) of Academic Interest:
Academic Honors:
Position: Shot/Catch: Years Playing:
Team 1: Number:
Number of games: Goals/GAA: Assists/Save%:
Coach: Phone: E-mail:
Team 2: Number:
Athletics Honors:
Other Sports:
For more information please contact: Head Coach - Jodi McKenna (jamckenna@wesleyan.edu) Office: 860-685-2904 Assistant Coach - Stephanie Boulay (sboula@wesleyan.edu) Office: 860-685-3216
Please return form via e-mail or to: Freeman Athletic Center, 161 Cross Street, Middletown, CT 06459 Fax: 860-685-2691
