Online Recruiting Questionnaire

GENERAL:

Name:                         
Date:
Social Security No.(optional):  Birth Date:
Street Address:     
City:
State:    Zip:
Phone: E-Mail:

Parents' Names:
Occupations:

ACADEMIC:

Graduation Year: 2005 2006 2007 2008 2009 2010     

High School:

School Address:  

School Phone:

G.P.A.    Class Rank of                     S.A.T. Scores  V:  M:

Interest of Study at Lock Haven:

Guidance Counselor:   

Phone:

Junior College/Other College Attended (if any):

ATHLETIC:

Position:    

RT/LT Handed:    Height:   Weight:    

Number of years you have played:

Number of years on high school/prep school varsity team:

Coaches Name(s):   
Phone:

Camps/Clinics attended (YR, awards):

Club Team:

Club Team Coach:  Club Coach Phone:

Other sports you participate in:

List any serious injuries you have had:

List any athletic awards you have received 
(e.g. MVP, All-Conference, All-Star Teams, etc.):

Tape of skills and/or competitions available?     Yes     No

LHU Men's Soccer
Head Coach Doug Moore
Assistant Coach Jon Davy
Thomas Fieldhouse
Lock Haven University
Lock Haven, PA 17745
O: (570) 893-2192
F: (570) 893-2414