Soccer Information Form

Email Secondary Email

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Email address *

First Name: *

Last Name: *

Address 1 *

Address 2

City *

State *

ZIP Code *

Cell Phone Number *

Date of Birth

Date Picker

High School Graduation Date

High School Name

High School Address

Intended College Major

Other Academic Interests

High School Coach

High School Coach Phone

High School Coach Email

Club Team(s)

Coach's Number/Email

Height

Weight

Primary Position

Secondary Position

Run Time: 40 Yard Dash

Kicks:

Left Right Both

Goal Keeper:

Right Left

Academic and Athletic Awards/Accomplishments

If you have a video of your skill, please provide the link

* required field

Coastal Bend College The Home of Cougar Athletics