USM Athletics Department

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RECRUITING FORM

Please fill out the following information and press the SUBMIT button once:

PERSONAL INFORMATION

First Name Last Name

Address

City State Zip

E-mail

Home Phone Cell Phone

H.S. Graduation Year

Parent/Guardian's Name Relation

Parent/Guardian's Name Relation

ACADEMIC INFORMATION

Name of High School School Website

City State

Class Rank out of GPA

S.A.T.: Critical Reading Math Writing Date Taken

Composite ACT Score

Expected College Major(s) or Academic Interests

Relatives/Friends who attend/attended or are affiliated with USM

List up to 6 other schools you are considering:

ATHLETIC INFORMATION

Total # of years of soccer experience Position Height Weight

HIGH SCHOOL
Team Name # of Years Played Jersey #
Coach Work Phone Cell Phone
Home Phone Email

CLUB TEAM
Team Name # of Years Played Jersey #
Coach Work Phone Cell Phone
Home Phone Email

ODP TEAM
Team Name # of Years Played Jersey #
Coach Work Phone Cell Phone
Home Phone Email

Soccer Awards:

Other Sports Played:

Other Athletic Awards:

Clicking the "SEND" button will send this information to Head Coach Lisa Petruccelli:

Click Button Once to

Click to

OR, print the PDF version of this form and mail it to Coach Petruccelli at the address below:

by e-mail:	lpetruccelli@usm.maine.edu
by FAX:	(207) 780-5182
by US Mail:	Coach Lisa Petruccelli 224 Costello Sports Complex University of Southern Maine 37 College Avenue Gorham, ME 04038-1083

Or call Coach Petruccelli for more information: (207) 780-5328


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