Rockford University Athletic Visit Request Form

Coach's Name *

Sport *

Prospect's Information

First Name *

Last Name *

Address *

Date of Birth *

City *

State *

Zip Code *

Home Phone Number

Cell Phone Number *

Email address *

High School Graduation Year *

What Type of Prospect? *

High School 2-Year School Transfer 4-Year School Transfer

Date(s) of Visit *

Are We Providing Transportation? *

Yes No

If yes, who will be providing it?

(Name)

Overnight Housing? *

Yes No

If yes list student host(s)?

Location of student host

Are we providing meals? *

Yes No

Location of meal(s)

Day 1

Breakfast Brunch Lunch Dinner

Day 2

Breakfast Brunch Lunch Dinner

List anyone other than the recruit who is eating *

Is athletics covering the cost of those meals?

Yes No

If no, who is covering the cost of the meals?

Is athletics providing entertainment money? *

Yes No

If yes, what will the money be used for?

* required field