MERCER MEN'S SOCCER PROSPECTIVE PLAYER QUESTIONNAIRE    
Please fill out form as completely as possible

*required field


Personal Information

*Name:        
Cell Phone: Home Phone:
 
E-Mail: Date of Birth:
 
Address:        
City: State: Zip:


Family Information
Father's Name: Occupation:
Address, City, State, Zip (if different):
 
Father's Phone    
Mother's Name: Occupation:
Address, City, State, Zip (if different):
 
Mother's Phone:    

 

Siblings/Relatives You Live With (include name, age & relationship of each):




Academic Information

High School/Prep School Name:        
HS Address:        
HS City: HS State: HS Zip:
HS Phone Number: Graduation Date:    
HS Counselor's Name:        
Core Grade Point Average:        
SAT Overall Score: SAT Math Score:    
SAT Written Score: SAT Reading Score:    
ACT Composite Score:        
TOEFL (if an international student):        

List any other high schools you attended (with address and grade point average there):


Are you registered with the NCAA Clearinghouse? Yes   No


What are your top 3 choices as a possible academic major?
1.   2.   3.


Transfers Only

List All Other Schools Attended (in order, most recent first)

School                              Location                          GPA & Credits                  Years Attended
      

      

      


Men's Soccer Information


High School
Coach:
HS Coach's
Phone:
HS Coach's
E-Mail:
   
HS Position:

HS
Jersey #:



   
HS
Honors:




     
               
Club Team:

Club Team
Coach:
Club Coach
Phone:
  Club Coach's
E-Mail:
Club
Position(s):
Club
Jersey #:
       
Club
Honors:
 


   


Please list any tournaments you are attending:


Other games - HS or Club - where we might be able to see you play (please provide dates):


Do you have video available of yourself?: Yes   No
(if "Yes", please send to us ASAP)


Other colleges you are considering:

 

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