Shepherd College Women's Soccer Questionnaire

PERSONAL

Name:___________________________________Soc. Sec. No._________________

Current address:__________________________________________________

City:_________________________State:______________Zip:___________

Date of Birth:__________________________________________________

Home Phone: _____________________Work phone:______________________

Parents or Guardians:_______________________________________________

Parent's Occupations: Mother:____________________Father:__________________

ACADEMIC

High School:______________________________Graduation Date._________________

School address:__________________________________________________

City:_________________________State:______________Zip:___________

School Phone:__________________________________________________

Principal:_________________________Guidance Counselor:____________________

School Phone:__________________________________________________

Class Rank:_________________________Grade Point Average:______________Desired Major:___________

Academic Honors:__________________________________________________

How many years in each of the following will you have completed upon graduation?

English______Algebra_______Geometry_______Physical Sciences______

Have you registered with the NCAA Clearinghouse?_____________________Have you taken your College Board exam?_____________________

If not, when?____________SAT score:_____Verbal________Math_______ACT Score________

ATHLETIC

Height:______________________Position(s)._________________

Uniform Number: Home:__________Away:_______________________________

High School Coach:_________________________State:______________Zip:___________

Coach's Office Phone:_______________________Coach's Home Phone:___________________________

Club Team:______________________Club Coach:___________________________

Club Coach Contact Information:__________________________________________________

Individual/Team Athletic Honors:______________________________________________________________________________________________

_________________________________________________________________________________________________________________________

Level of interest in Shepherd College: Strong______Moderate_____________Not Sure_____________________

Please include your club and or high school schedules and mail to:

Head Coach Jim Sweeney, Women's Soccer Office

Shepherd College, P.O. 3210, Butcher Center,

Shepherdstown, WV 25443-3210