Transfer/Walk-on Student Athlete Questionaire
Please be advised that the following information is necessary in order to determine your eligibilty for participation.

In State (New York)      Out of State     Foreign (Student Visa) 

If already at Queens College, what term ae you in? 

Sport(s): 
               
               

Do you have a videotape available for the coach's viewing?  Yes    No 

Personal Information
Full Name: 
Address:    
City:     State:    
Zip:  
Home Phone:     
Cell Phone:        
E-Mail Address: 
Height:           
Weight:          
Date of Birth: 
Social Security Number (necessary in order to access your information at the NCAA Eligibilty Center):          

Parent/Guardian Information
Parent/Guardian Name: 
                                      
Parent/Guardian Address (if different than above) : 
City:     State:    
Zip:  
Parent/Guardian Phone: 

High School Information
High School:                
Graduation date:        

Name of 1st College and dates of enrollment:
From    to 
Sport(s) played:    # of years: 
Sport(s) played:    # of years: 

Name of 2nd College and dates of enrollment:
From    to 
Sport(s) played:    # of years: 
Sport(s) played:    # of years: 

Name of 3rd College and dates of enrollment: 
Sport(s) played:    # of years: 
Sport(s) played:    # of years: 

Type of Degree earned: 
  Associates Degree in: 
  BA/BS in: 
  Other (Please list): 

If applicable, please list any years when you were not enrolled in High School or College:
From        to   
Reason 
From        to 
Reason 
From        to 
Reason 
From        to 
Reason 
Did you begin any semester and withdraw?  Yes    No 
If yes, please list school name: 
Year and semester: 

Additional Information
Have you filed with the NCAA Eligibilty Center?  Yes     No 
If no, please visit the following website in order to register:
https://web1.ncaa.org/eligibilitycenter/common/
If yes, what is your Clearing House ID #?  
If yes, what is your Amateur Decision Status?  Certified     Not Certified 
If yes, please select which status applies to you:   Partial Qualifier    Non Qualifier 
TOEFL Score (Foreign Students Only): 
Have you applied to Queens College?  Yes     No 
Term you plan to begin college: 
Year you plan to begin college:  
Intended major: 

If not a US citizen, please list country of citizenship: 
Type of Visa: 

I certify that, to the best of my knowledge, the information I have provided is complete and correct.
  Date
Please type name above. This will serve as your electronic signature.

Please submit electronically by clicking below:



If you are unable to submit electronically, please print and send to:
Merlin Thompson
Athleic Department
Queens College
65-30 Kissena Blvd.
Flushing, NY 11367-1597