Southern Maine Huskies
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Recruiting Form

Please fill out the following information and press the SUBMIT button once:
(Note: highlighted fields are required.)


Name

Address

City State Zip

Phone E-mail

Parent's Name

High School

School Address

H.S. Coach Phone

Club Coach Phone

Graduation Date Class Rank GPA

S.A.T.: Verbal Math Date Taken

Planned College Major(s)



Position Years as a Starter

Current Year's Stats: Games Goals Assists

Goals Against Avg. Shutouts

Honors and Awards:


Coach's Comments (optional):
You may have your coach e-mail comments separately: mkeller@usm.maine.edu


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If you'd prefer, send this information to Coach Mike Keller:

by e-mail: mkeller@usm.maine.edu
by FAX: (207) 780-5994
by US Mail: Coach Mike Keller
University of Southern Maine
37 College Avenue
Gorham, ME 04038-1083

Or call Coach Keller for more information: (207) 780-5594