Wisconsin-Milwaukee Soccer Recruiting Form

The information you submit via the form will be sent to the UW-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:

Jon Coleman, Head Coach
UW-Milwaukee Panthers Men's Soccer
Athletic Department - Pavilion
3409 N. Downer Avenue
Milwaukee, WI 53211

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):
Year of Graduation:
Other Pertinent Information: