800 University Way | Spartanburg, SC 29303

PERSONAL INFORMATION
Name:
Nickname:
Age:
Date of Birth (mm/dd/yyyy):
SSN:
NCAA Eligibility Center ID:
Email:
Home Address:
City:
State:
Country:
Zip:
Home Phone:
Cell Phone:
Father's Name:
Occupation:
Mother's Name:
Occupation:

ACADEMIC INFORMATION
Current School:
Address:
City/State/Province/Zip:
GPA (High School 4.0 Scale):
Graduation Year:
Have you taken the SAT?:	YES NO
SAT Date (mm/dd/yy):
SAT Verbal:
SAT Math:
Have you taken the ACT?:	YES NO
ACT Score:
Next ACT Test Date (mm/dd/yy):

ATHLETIC INFORMATION
High School Team:
Positions:
Jersey #:
Years Played High School:
Years Played Youth/Club:
High School Coach (Name and Phone):
Soccer Achievements (All-League/State, MVP, Captain, etc:
Other Activities/Sports:
Other Athletic Achievements:
Interests:
Height:
Weight:
Most Recent Club Team:
Club Position:
Jersey #:
Club Coach (Name and Phone):
Club Tournaments:
Olympic Develompent Experience?:	YES NO
# of years?
ODP Coach (Name and Phone):
Regional Camp?	YES NO
# of years attended:
Regional Team Selection:	YES NO
# of years?
Regional Team Coach (Name and Phone):
National Camp?	YES NO
50-yard Dash Time:
100-yard Dash Time:
Mile Time:
What College Tournaments will you attend within the next year?
1.
2.
3.
If we saw you play at a tournament, which was it?
1.
2.
3.
Game Films/Tapes available?	YES NO
If yes, contact?

UNIVERSITY INFORMATION
Universities that have made contact with you
1.
2.
3.
Universities you are interested in (in order of preference)
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5.
Career Plans:
Intended Major:

PERSONAL INFORMATION

ACADEMIC INFORMATION