Fall 2010-11
Recruitment Form

---

Player Information

^{Name:        Student ID:}

^{Birth Date:}   (mmddyyyy)

^{Address:    City:}     AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VA WA DC WV WI WY ^Zip:    

^{Home Phone#:         Cell Phone#:}   

^{E-Mail Address:}       

---

Hockey Information

^Position:      __Position__ Center Left Wing Right Wing Defense Goalie    ^{Shot/Catch:  Left     Right}      

^{Height:         Weight:}         

^{Jersey Size: ____Jersey Size____ Small Medium Large X-Large XX-Large XXX-Large        Warm-Up Size: ____Jacket Size____ Small Medium Large X-Large XX-Large ____Pant Size____ Small Medium Large X-Large XX-Large}

^{Previous Team:       Highest Level of Play:    ____Playing Level____ High School AA Club AAA Club Junior B Junior A ACHA College Other}   

^{What is your Level of Interest?   ____Interest____ Somewhat Interested Very Interested Accepted and Interested Accepted and Attending}

HOME8