Men's Rugby Prospective Athlete Questionnaire

Email Secondary Email

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Email address *

First Name *

Middle Name *

Last Name *

Date of Birth *

Home Address *

City, State, Zip Code *

E-Mail Address *

Home Telephone Number *

Cell Phone Number

List your Social Media Handles (Twitter, Instagram, SnapChat, etc.)

Name of High School (Graduation Year) *

Class Rank

Grade Point Average

ACT/SAT Score

Academic Interests

Clubs/Organizations/Awards

Position *

Height/Weight *

List Statistics and Athletic Honors

Do you have Rugby Experience (If yes, please explain) *

Club/Team Name? *

Are Video Tapes Available? *

Yes No Already Sent

If YES to video tapes, please paste link:

Explain your Rugby-Specific Strengths & Weaknesses

List you Maximum Lifts for Bench, Squat, Deadlift & Power Clean *

What is your Bronco Score?

Coach's Name

Coach's Phone

Coach's E-Mail Address

Are you a Transfer Student? (If yes, list previous school) *

Have You Already Applied to Adrian College? *

Yes No

Would you like to Schedule a Visit to Adrian College Campus? *

Yes No

* required field