Milwaukee Athletics - Athletics News

Wisconsin-Milwaukee Soccer Recruiting Form

The information you submit via the form will be sent to the The information you submit via the form will be sent to the Milwaukee Soccer Coaching Staff. All the fields in red must be completed. If you can not submit the information electronically, print the form off and mail it to:

Michael Moynihan, Head Coach

Milwaukee Panthers Women's Soccer

North Building

PO Box 413

Milwaukee, WI 53201-0413

Personal Information
Name:
SS#: (xxx-xx-xxxx)
Graduation Date
Street:
City:
State:
ZIP:
H Phone:
Fax:
Email:
Age: HT: WT:
Birthdate (xx/xx/xx):
Father's Name
Father's Occupation
Father's Employer
Mother's Name
Mother's Occupation
Mother's Employer
Siblings Names & Ages:

High School Academic Information
High School:
H.S. Phone:
H.S. Fax:
H.S. City:
H.S. Coach's Name:
H.S. Coach's Phone:
Current GPA/Scale (3.21/4.00):
Class Rank (34 of 114):
ACT:
SAT:
Academic Interests:
Academic Awards:
Planned Major:
Have you registered with NCAA Clearinghouse?	Yes No
If yes, approximate date registered (mm/dd/yy):

High School Soccer Information

Primary Position:

Years On Varsity:

Team Record

Sophomore:
Junior:
Senior:

	Goals	Assists
Sophomore
Junior
Senior

Number of Games Played

Sophomore:

Junior:

Senior:

If GK, List Applicable Stats

	GAA	SO
Sophomore:
Junior:
Senior:

Individual Award Honors:

Team Honors:

ODP & Club Soccer
Name of Most Recent Club Team (List Years):
Coach(es)
Coach's Phone
Coach(es)
Coach's Phone
Highest Level of Club Team Accomplishments & Years:
List Any Other Pertinent Club/Individual Team Information:
ODP State Team Experience (List Years):
Primary Positions Played:
Coach(es)
Coach's Phone
Coach(es)
Coach's Phone
ODP Regional/National Experience (List Years):
Coach:
Coach Phone:

Miscellaneous
What Schools Have Contacted You Directly About Playing Soccer:
What Schools Are You Most Interested In Attending:
Have you applied to Wisconsin-Milwaukee?	Yes No
If Yes, Approximate Date (mm/dd/yy):
Other Pertinent Information: