GENERAL:

Name:                         
Date:
Social Security No.(optional):  Birth Date:
Street Address:     
City:
State:    Zip:
Phone: E-Mail:

Parents' Names:
Occupations:

ACADEMIC:

Graduation Year: 2007 2008 2009 2010 2011 2012 2013 2014     

High School:

School Address:  

School Phone:

G.P.A.    Class Rank of                    
 S.A.T. Scores  V:  M:

Interest of Study at Lock Haven:

Guidance Counselor:   

Phone:

Junior College/Other College Attended (if any):

ATHLETIC:

RT/LT Handed:    Height:   Weight:    

Number of years you have wrestled:

Number of years on high school/prep school varsity team:

Coaches Name(s):   
Phone:

Camps/Clinics attended (YR, awards):

Other sports you participate in:

List any serious injuries you have had:

List any athletic awards you have received 
(e.g. MVP, All-Conference, All-Star Teams, etc.):

Tape of skills and/or competitions available?     Yes     No

LHU Women's Wrestling
Head Coach Terry Fike
Administrative Assistant: Wally Kocher
Thomas Fieldhouse
Lock Haven University
Lock Haven, PA 17745
O: (570) 484-2304
F: (570) 484-2414