BENEDICTINE UNIVERSITY
MEN'S SOCCER

PERSONAL INFORMATION

FIRST NAME  
LAST NAME  
ADDRESS  
 
CITY  
STATE  
ZIP  
HOME COUNTRY  
HOME PHONE  
CELL PHONE  
EMAIL  
DATE OF BIRTH  
MOTHER'S FIRST NAME  
MOTHER'S LAST NAME  
FATHER'S FIRST NAME  
FATHER'S LAST NAME  
OTHER SCHOOLS INTERESTED  
ARE YOU REGISTERED WITH THE ELIGIBILITY CENTER?  
IF YES, WHAT IS YOUR ELIGIBILITY CENTER ID?  

ACADEMIC INFORMATION

GRADUATION YEAR  
 

For the school field, type the first few letters of your school name, and a dropdown should appear in which you can click on your school. If it does not appear, try an alternate name. If neither attempt gives you your school, manually enter the info.

HS/COLLEGE NAME  

HS ADDRESS  
 
HS CITY  
HS STATE  
ZIP  
HS PHONE  
GRADE POINT AVERAGE  
ACT  
SAT MATH  
SAT VERBAL  
INTENDED MAJOR  
HS CLUBS OR ACTIVITIES  
VOLUNTEER WORK OR COMMUNITY SERVICE  

ATHLETIC INFORMATION

CLUB TEAM NAME  
POSITION  
HEIGHT  
WEIGHT  
CLUB JERSEY NO  
HS JERSEY NO  
ATHLETIC HONORS  
OTHER SPORTS PLAYED  
 
PLEASE CERTIFY THAT YOU ARE A HIGH SCHOOL JUNIOR OR SENIOR, OR ARE A CURRENT COLLEGE STUDENT   Yes, it is AFTER September 1st of my Junior year of high school.
No, it is BEFORE September 1st of my Junior year of high school.