Southern Poly Soccer Questionnaire

Personal Information

Full Name:
Address: Street
City
State  Zip
Birthdate:
Phone:
Cell Phone:
Email:
Parent/Guardian: Mother Father Other
Parent Occupation: Phone:
Parent/Guardian: Mother Father Other
Parent Occupation: Phone:

High School Information

High School:
H.S. Graduation Date:
ACT/SAT Score: H.S. GPA:

College Information

Previous College(s):
Currently Enrolled: Yes No
Total Credits Earned: Academic Status:
Intended Major: Overall GPA:

Athletic Information

Height:    
Weight:    

Position(s):
Club Coach's Name:
Club Coach's Phone:
Club Coach's Email:
Club Team:
High School Coach's Name:
High School Coach's Phone:
High School Coach's Email:
Other Sports:

Additional Information

Do you have any video that you can send us:     

Honors/Awards:

Comments / Personal Statement: