East Stroudsburg University Women's Soccer Recruiting Form


Name

Social Security #

Street Address

City
State
Zip Code

Home Phone
Work Phone

Birthdate (mm/dd/yy)
Height
Weight
Jersey #

Parents/Guardians Names

Occupation
Total Number in Family

E-Mail Address

Academic Information


High School

School Phone

School Address
City
State
Zip Code

Guidance Counselor

Academic Interest

SAT Score-Verbal
SAT Score-Math
ACT Score(s)

Grade Pt. Avg.
Class Rank
Graduation Date

Curriculum Desired in College

Have you filed with the NCAA Clearinghouse Yet?  YES NO

Athletic Information


High School Coach

Home Phone
Work Phone

Position(s)

Club Team

Club Coach

Club Coach Phone (Home)
Work Phone
Position(s)
Jersey #

ODP Team

Coach

Coach Phone (Home)
Work Phone
Position(s)
Jersey #

Team Accomplishments

Indvidual Accomplishments

Awards and Honors

Please list the names and dates of any fall or spring tournaments in whch you will be competing:
Video Tape Available  Yes No

Leave Any Comments or Questions for East Stroudsburg Coach Rob Berkowitz



Rob Berkowitz, East Stroudsburg University 200 Prospect Street East Stroudsburg , PA.   18301

570-422-3648 Office