EICCD - Scott Community College Soccer Recruit Questionnaire

EICCD : Athletics : Soccer Recruit Questionnaire

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Please complete the following information

Fields with a * are required.

(please include your area code)

General Information:

Name: *	High School or College:
Address: *	Address:
City, State, Zip: *	City, State, Zip:
Home Phone: *	School Phone:
Email:	H.S. Graduation Date:
Date of Birth:	G.P.A.:
Parent Names:	SAT/ACT Score:
Academic Interest:	Class Rank:
Academic Awards:	Counselor's Name:
Academic Awards continued:

Soccer Information:

High School:	Personal:
Years Played:	Height:
Position(s):	Weight:
Coaches Name:	Athletic Awards:
Coaches Phone:
Club:
Club Name:
City, State:
Years Played:
Position(s):
Coaches Name:
Coaches Phone:

Did you include a video tape? Yes No

(If no, please send at your earliest convenience.)

Comment about your experience, other sports or interests:

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