Boston University Athletics Official Athletic Site

Prospective Student-Athlete Questionnaire

Personal Information

* Required

*First Name:
*Last Name:
*Address:
*City:
*State:
*Zip:
*Home Phone:
*Cell Phone:
*E-Mail:
*Date:
*Ht:	Wt: Age:
*Birth Date:
Social Security #:
Father's Name:
Father's Occupation:
Work#:
E-mail:
College Attended:
Mother's Name:
Mother's Occupation:
Work#:
E-mail:
College Attended:
Brothers/Sisters:
In College:
Brothers/Sisters:
In College:
Academic Information
*High School:
PSAT Scores V:	M: Class Rank:
*Coach's Name:
*Home Phone:
SAT Score V:	M: W:
ACT Score:
TOEFL Score:

Foreign Students please list scores, records here:
Guidance Counselor:
Phone #:
E-mail:
Applied to BU: YES:	NO:
NCAA Clearinghouse: Have you registered? Yes:	NO:
NCAA Clearinghouse ID:
Early Decision: YES	NO: GPA:
Class Rank (_of_):
*Date of Graduation:
*Desired Course of Study:
Top 3 Priorities in choosing a colllege: 1:	2: 3:
Soccer Information
*Your Best Position:
*Dominant Foot:
*Other Positions Played:
Past Playing Expience
US National Youth Team: Coach:	Phone #: Dates:
USYSA Regional Team Coach:	Phone #: Dates:
USYSA State Team Coach:	Phone #: Dates:
Club Team Coach:	Phone #: Dates:
Do you have game and/or highlight film available?:

List other important soccer experiences: