Soccer Submission Form at Wallace State Community College

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Player Tryout Information Sheet

Are you interested in men's soccer at Wallace State College?
Please complete this online player profile.

Personal Information :
Student Name:	First	Middle	Last
	Call Name (name you answer to)
Date of Birth:	,
E-mail Address:	i.e. - you@address.com

Permanent Mailing Address:
Street:
City:		State:	Zip:
Country of citizenship:
Home Phone:		Work Phone: (include area code)
Have you applied to Wallace State? yes no If yes, when? ,
Have you applied for financial aid? yes no If yes, when? ,

Family Information :
Father's Name:	First	Middle	Last
Mother's Name:	First	Middle	Last
City:		State:	Zip:
Country of citizenship:
Phone:	(include area code)

Academic Information :
High School/Prep School attended:
Graduation Date: ,
City:		State:
Country:
Currently enrolled? yes no
Please list your high school honors, awards, and extracurricular activities:
If you are a transfer student, please list the names and dates of colleges that you have attended:

Athletic Information :
Height:	,	Weight: lbs.
Position:		Dominant Foot:
High School Coach: Phone: include area code
Club Team Name:
Coach: Phone: include area code
State/Olympic Development Team Info:
Athletic Honors:


	When you have completed this form, click on the Submit button below. Click only once on the submit button to send your response. This will forward your information to Coach Barry Spitzer. Thank you.