Prospective Athlete

Note: Required fields below marked with * must be completed in order to submit this form.

General Information

First Name: *
MI:
Last: *
Email Address: *
Home Phone: *
Cell Phone:
Age: *
High School:
City:
State:
High School Coach's Name:
Junior College:
City:
State:
Jr. College Coach's Name:

Academic Information

High School Graduation Date:   Class Rank: G.P.A.:
Jr. College Graduation Date: Hours Completed: G.P.A.:
SAT Scores: Reading: Math: Written:
ACT Comp Score:
Intended College Major:
Academic Accomplishments:
Certified by NCAA Clearinghouse? No Yes   Index Number:
Guidance Counselor's Name:   Phone:

Soccer Information

Main Position: Secondary Position:
Current Club Team: Previous Club Team:
Club Coach:    
Do you have a recent video? If so, would it be available to mail for viewing? Yes No