SUNY Cortland Gymnastics

Prospective Student-Athlete Questionnaire
GYMNASTICS


First Name*:
Last Name*:
Date of Birth:
Age:
E-mail Address*:
Home Phone*:
Cell Phone:
Street Address:
City:
State:	Zip Code:
Name(s) of Parent or Guardian:

ACADEMIC

High School:
Street Address:
City:
State:	Zip Code:
School Phone:
Guidance Counselor:
Are you taking a college prep curriculum?:
Present Grade:
College(s) Attended:
Year of Next Graduation*:
SAT: (math)	(writing) (critical reading)
ACT:
Grade Point Average:
Class Rank (XX out of XXX):
Have you applied for admissions to Cortland?:
If yes, Date of Application:
Intended Major:

ATHLETIC

PRESENT SKILLS
VAULT Tsukahara Tuck Tsukahara Pike Tsukahara Layout Tsukahara Tuck 1/2 Tsukahara Pike 1/2 Tsukahara Layout 1/2 Tsukahara 1/1 Front Handspring Front Tuck Front Handspring Front Pike Front Handspring Front Layout Front Handspring Front Tuck 1/2 Kasamatsu Tuck Kasamatsu Pike Kasamatsu Layout Yurchenko Tuck Yurchenko Pike Yurchenko Layout Yurchenko Tuck 1/2 Yurchenko Pike 1/2 Yurchenko Layout 1/2 Yurchenko 1/1 Handspring 1 1/2 Handspring 2/1 Other (list):	UNEVEN BARS Shootover to Handstand Straddle Back to Handstand Straddle Up to long hang kip Yeager Gienger Pak Salto Reverse Hecht Hindorff Shaposhnikova Cast Handstand Clear hip handstand Toe On Handstand Stalder handstand Back Stalder handstand Forward Handstand 1/2 Pirohuette Handstand 1/1 Pirohuette Back Giant Front Giant Eagle Grip Giants 1/2 Higgins 1/1 Higgins Blind Change 1/1 Giant (C variation) 1/1 Giant (D variation) Double back dismount Double Pike Double layout 1/2 in 1/2 out Full In Full Out Double Front Double Arabian 1/1 back 1 1/2 back 2/1 back 1/1 front 1 1/2 front 2/1 front Other (list):	BALANCE BEAM Straddle Jump Straddle Jump 1/2 Straddle Jump 3/4 Straddle Jump 1/1 Tuck Jump 1/2 Tuck Jump 1/1 Tuck Jump 1 1/2 Wolf Jump 1/2 Wolf Jump 3/4 Wolf Jump 1/1 Pike Jump 1/2 Pike Jump 3/4 Pike Jump 1/1 Cat Leap 1/2 Cat Leap 1/1 Cat Leap 1 1/2 Spilt Jump 1/2 Spilt Jump 3/4 Spilt Jump 1/1 Tour jete 1/2 Tour jete 1/1 Ring Leap Sheep Jump Switch Leap Switch Ring Switch Side Leap 1 1/2 Turn 2/1 Turn One arm handstand Side Aerial Front handspring step out Front handspring two feet Front aerial Front aerial – Front aerial Front Tuck Back Tuck Back Pike Back Layout Back handspring BHS-BHS BHS- Layout step out BHS-Layout-Layout BHS- Back Tuck BHS- Layout (two feet) Front tuck Mount Round-off BHS Mount Round-off Back layout Mount Planche Mount Front layout dismount Front 1/1 dismount Rudy dismount Gainer layout dismount Gainer 1/1 dismount Round off 1/1 dismount Round off 1 1/2 dismount Round off 2/1 dismount Round off double back dismount Other (list):	FLOOR Back somersault 1/1 Back somersault 1 1/2 Back somersault 2/1 Back somersault 2 1/2 Back somersault 3/1 Double back somersault Double back somersault with 1/2 Double back somersault with 1/1 Front Somersault Layout Front Somersault Layout 1/2 Front Somersault Layout 1/1 Front Somersault Layout 1 1/2 Front Somersault Layout 2/1 Tsukahara Pike Double Arabian Front Layout Front Layout Front Layout Front 1/1 Front 1/1 Front Tuck Front 1/1 Front Pike Front 1/1 Front Layout Front 1/1 Front 1/1 Back whip Back whip 1/2 Back somersault 1 1/2 front tuck Back somersault 1 1/2 front pike Back somersault 1 1/2 front layout Popa Wolf 1/1 Wolf 1 1/2 Other (list):

Height:

ft inches

Skill Level:

Club Coach Name:

Club Coach's Home Phone:

Club Coach's Work Phone:

Club Coach's Email:

Other Sports You Compete in:

Individual Athletic/Academic Honors Won:

Activities/Hobbies (non-sports):

List any serious injuries: