Avila Athletics - Dance Team Questionnaire


	Avila University Dance Questionnaire
	11901 Wornall Road Kansas City, Missouri 64145	Phone: 816.942.8400 ext. 3634 Fax: 816.941.4503

	Please fill out the following information. The fields with asterisks are required.

	Personal Information
	First Name *	Last Name *
	Phone * (ex: 555-555-5555)	Email address
	Street *	City *
	State *	Zip *
	Contact besides yourself (mom, dad, guardian):

	Dance Information
	Studio Name	Years Experience
	Teacher/Coach	Teacher/Coach Phone
	Individual/Team Honors
	Types of Dance Ballet Jazz Tap Pom Modern/Lyrical
	High School Dance Experience Yes No
	HS Coach's Name	HS Coach's Phone
	HS Individual/Team Honors

	Academic Information
	High School	Graduation Date
	High School GPA	Class Rank
	ACT score	SAT score
	Planned date for (re)taking the SAT/ACT?	Community College
	Total hours	GPA
	Intended major	Other colleges you are interested in?


	Thank you for your interest in Avila Athletics! Someone will be contacting you shortly!

	Dept. of Athletics 11901 Wornall Road Kansas City, Missouri 64145 816.942.8400 ext. 3634 fax 816.941.4503