BENEDICTINE UNIVERSITY
WOMEN'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

HS NAME  

GRADUATION YEAR  
HS ADDRESS  
 
HS CITY  
HS STATE  
ZIP  
HS PHONE  
CLASS RANK  
GRADE POINT AVERAGE  
ACT  
NEXT SCHEDULED ACT TEST  
SAT TOTAL  
ACADEMIC INTERESTS  

ATHLETIC INFORMATION

HS COACH'S FIRST NAME  
HS COACH'S LAST NAME  
HS COACH'S EMAIL  
HS COACH'S CELL PHONE  
 

HOLD THE 'CTRL' KEY ON A PC, OR THE 'APPLE' KEY ON YOUR MAC TO SELECT MULTIPLE OPTIONS

POSITION  
HEIGHT  
WEIGHT  
HS JERSEY NUMBER AND COLOR  
HS CAREER STATS  
 

CLUB TEAM

CLUB TEAM NAME  
CLUB COACH'S FIRST NAME  
CLUB COACH'S LAST NAME  
CLUB COACH'S EMAIL  
CLUB COACH'S CELL PHONE  
CLUB JERSEY NUMBER AND COLOR  
CLUB CAREER STATS  
TOURNAMENTS ATTENDING  
ADDITIONAL TOURNAMENTS ATTENDING  
ODP EXPERIENCE  
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.