Contact the football Coach

Fill out this form to let the coach know of your interest in playing football at Eureka.

 

 

Personal Info

 

First Name:

*required

Last Name:

*required

Preferred Name:

Street Address:

*required

City:

*required

State/Province

*required

Zip/Postal Code

*required

County:

Probable Major:

Entry Term:

Phone Number:

*required

Cell Phone Number:

Email:

*required

When do you plan to visit?

High School:

 Coach:

Yr. of Graduation:

 Birthday

High School GPA:

on a pt. scale

Class Rank:

in a class of

ACT Composite:

and/or SAT V: M:

Height:

Weight:

What other colleges are you considering?

For Transfers Only

 

Colleges attended:

Associate Degree Earned?

Yes No   Date:

Eligibility Remaining:

GPA:

Hours earned:

Athletic Info

 

40 Yard Dash:

Jersey Number

Stats / Awards:

Football Position

Current / Former Eureka College
students & alums that you know:

 

 

 

 

  
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