Name (First)	(Middle)	(Last)
Address
City	State	ZIP
Home Phone	Cell Phone
Email Address
Birthdate	Screen Name
Father's Name	Occupation
Mother's Name	Occupation
Living With? (Check One) Mother Mother Both Other
Brothers/Sisters (Age, Name)
Who will help you make your college choice
ATHLETIC INFORMATION
Level 9 Regional 9 National 10 Regional 10 National Elite
Club Name	Club Coach
Address
City	State	Zip
Club Phone	Club Email
Vault     Yurchenko Tsukahara Handfront Front Handspring onto board Yurchenko - Full on entry Other	Body Position     Tuck Pike Layout Other	Twist     1/2 1/1 1 1/2 2 Other
Other
Bar Release     Jaeger - tuck Jaeger - straddle Jaeger - pike Jaeger - other Geinger Geinger - 1 1/2 Khorkina Tkatchev Tkatchev - tuck Tkatchev - pike Tkatchev - 1/1 Hindorff Toe shoot Tkatchev Shaposhnikova Toe shoot Shaposhnikova Swing Front Bail Bail to Handstand Straddle Back Straddle Back to Handstand Uphill Other	Dismount     Double Tuck Double Pike Double Layout 1/2 in 1/2 out Full in Full out Double Lay 1/1 Double / Double Toe Front Toe Front 1/2 Toe Front 1/1 1/2 in Double Front Double Front Front 1/2 Front 1/1 Front 1 1/2 Front 2/1 Back 1/2 Back 1/1 Back 1 1/2 Back 2/1 Back 2 1/2 Back 3/1 Other	Other
Beam Flight     Flic + Flic Flic + Tuck Flic + Pike Flic + Lay Flic + Splashdown Flic + Flic + Tuck Flic + Flic + Pike Flic + Flic + Lay Flic + Flic + Splashdown RO + Flic RO + Tuck RO + Pike RO + Lay RO + Flic + Lay Flic + Lay + Flic Flic + Lay + Lay Fhs + Flic + Lay Other	Dismount     Front - tuck Front - pike Front - layout Front - 1/2 Front - tuck - 1/1 Front - lay - 1/1 Front - lay - 1 1/2 Front - lay - 2/1 Gainer Gainer - 1/1 Gainer - 1 1/2 Gainer - 2/1 Gainer - pike off end of beam Gainer - 1/1 off end of beam RO - 1/1 RO - 1 1/2 RO - 2/1 RO - 2 1/2 RO - 3/1 RO - Double back Double Front Other	Other
Floor
1st Pass
2nd Pass
3rd Pass
4th Pass
Michigan State Gymnastics Questionnaire
Injury
Injury
Injury
Injury
Injury
High School	Counselor
Graduation Date	SAT	ACT
Core GPA
HS Phone
Intended Major
Other