Former Saluki Student-Athlete Questionnaire

Former Saluki Athletes and Coaches! Please stay in touch with Southern Illinois University Athletics by filling out this questionnaire. The information requested on this form is very important to us, so please be as thorough as possible.

Please fill in the following:

Your full name (First, Last, Maiden)

Street Address

City, State

Zip Code

Daytime Phone

Evening Phone

E-Mail Address

Fax Number

Occupation

Hometown

High School

What sport(s) did you participate in/coach at Southern Illinois University?

Years participated/coached (e.g. 1969-73)

If you played a sport at Southern Illinois University, who was your coach?

Did you graduate from Southern Illinois University?

Would you like to receive schedules and ticket information for any athletic sport at Southern Illinois University?

If yes, which sport(s)?

Are you currently a member of the Saluki Athletics Scholarship Fund (SASF)?

Any additional information about yourself: