*First Name
Middle Name
*Last Name
 
Player Status Entering UCCS
Applied:
*Graduation Year:
*Email Address
*Street Address, City
*State:
*Zip
*Phone:
*Cell Phone:
 
Academic Interest
NCAA Eligibity #
HS Name
HS Address
HS GPA
ACT Score
SAT Score
HS Honors
 
HS Coach's name Club Team Name
HS Coach's e-mail Club Coach's name
HS Coach's Phone Club Coach's e-mail
HS Jersey # Club Coach's Phone
Role on HS team Club Jersey #
    Role on Club team
 
Height
Weight
   
Position (Select all that apply):
 
Upcoming Tournaments you will partcipate in with Dates/Additional Comments
Attach Player Profile
Recruitment Web Address (Youtube, Captain U etc)
*
Validation Code
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* denotes required field
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