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CSUB Women's Cross Country Prospective Athlete Questionnaire
If you are interested in CSU Bakersfield Women's Cross Country please respond to the following questions, giving as much information as possible. If you have any questions about the program, please contact Director of Cross Country Marcia Mansur-Wentworth via email at mmansur@csub.edu or by phone at 661-654-3476.

Required Fields in Bold

 
Contact Information

Full Name
 
Mailing Address
 
City
 
State
 
Zip
 
Home Phone
 
Cell Phone
 
Email Address
 
 
High School Information

High School
 
Location (City, State)
 
Year Graduating/Graduated
 
Top Time/Distance
 
Track & Field Events/Top Times (if applicable)
 
Athletic Awards/Accomplishments
 
High School Coach
 
High School Coach Contact Number
 
 
Previous College Information

Name(s) of College(s)
 
Location (City, State)
 
Did you run cross country at the college(s) listed above?
 
Yes
No
Top Time/Distance
 
Track & Field Events/Top Times (if applicable)
 
 
Athletic Awards/Accomplishments
 
College Coach(s)
 
College Coach(s) Contact Number(s)
 
 
Academic Information

SAT and/or ACT Scores
 
Current Grade Point Average
 
Academic Interests (What would you like to study in college?)
 
 
Additional Information

Are you registered with the NCAA Clearinghouse?
 
Yes
No
NCAA Clearinghouse Number
 
Height
 
Weight
 
What are your athletic goals?
 
Are you interested in visiting the CSU Bakersfield campus? (If so, please provide general information about when you would be available.)
 
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