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     Prospective Player Profile

Personal Information
First Name:
Last Name:
Address:
City:
State:
Zip Code:
Telephone (include area code):
E-mail:
Date of Birth:
Hobbies/Interests:
Family Information
Father
Name:
Occupation:
Home Phone (include area code):
Work Phone (include area code):
Mother
Name:
Occupation:
Home Phone (include area code):
Work Phone (include area code):
Athletic Information
Height:
Weight:
Position(s) Played:
Other Sports Participated in:
Academic and athletic awards:
Soccer references (coaches, teachers, ect.):
Your interest in Parkland:	Strong Average Mild
Other colleges of interest:	1 2 3 4
List top athletes you have competed against:	1 2 3 4
Academic Information
Class Rank:	in a class of
GPA:	on a scale of
ACT and/or SAT composite:
Date taken:
Graduation date:
Counselor's name:
Counselor's school phone (include area code):
School name:
School phone (include area code):
Coach's name:
Coach's home phone (include area code):
School Address:
School City:
School State:
School Zip Code:
Major or academic area of interest:

Parkland College • 2400 West Bradley Avenue • Champaign, IL 61821 • 217/351-2200 • 800/346-8089
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