NOTE: This form is not an official Butler University application. This form will be used by the coaching staff to help determine prospective student-athletes.

WARNING: NCAA rules prohibit coaches from contacting freshmen and sophomores in high school. Only junior, senior and preparatory students are permitted to use this form.

Butler University Athletic Recruiting Questionnaire
Sport You Are Interested In At Butler University (Determines Coaches that will receive this form):
		Baseball M-Basketball W-Basketball Football M-Golf W-Golf M-Lacrosse M-Soccer W-Soccer W-Softball Swimming Tennis XC/Track & Field Volleyball
Your e-mail address:
Tell us something about yourself
Last Name:
First Name:
Middle Name:
Nickname:
Address:
City:
State or Country:
Zip Code:
Phone Number/Fax Number:
Date of Birth:
Planned College Major:
Sport(s) you want to be recruited:
Height:
Weight:
Position:
Tell us something about your family
Father's Name:
Occupation:
Alma Mater:
Business Phone/E-Mail:
Mother's Name:
Occupation:
Alma Mater:
Business Phone/E-Mail:
Brothers and Sisters (Name/Age):
Your Academics
School:
Address:
City:
State or Country:
Zip Code:
PSAT Score:
SAT Score: Verbal:
SAT Score: Math:
SAT II Scores (Please List Subject and Score):
SAT II Scores (Please List Subject and Score):
SAT II Scores (Please List Subject and Score):
ACT Score: Composite:
Academic Honors:
Year/Graduation:
Class Rank (Out of Number In Class)
GPA (4.0=A):
Guidance Counselor:
School Phone:
Languages you speak Fluently:
If Foreign, how many years of English have you taken?:
Your Athletics
High School Coach:
Home Phone:
Club Coach:
Home Phone:
Club Name:
Jersey Number
Sports Goals/Background
Please list your specific best times, marks, stats, scores by event:
Please list your specific sport honors and/or awards.
Other schools you are interested in?
Please list any friends or relatives that are Butler alumni:
Use this space to add anything else your believe is pertinent to your application and to add anything else you wish to tell the Butler Coaching Staff.
Will you be applying for financial aid? Please Type Yes or No.