USM Athletics Department

Recruiting Form

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

Date PERSONAL INFORMATION
First Name		Last Name
Nickname
E-Mail Address		Home Phone
Mailing Address
Father's Name		Father's Occupation
Mother's Name		Mother's Occupation
Do you know anyone who has attended or is associated with USM? Yes No If so, who?
ACADEMIC INFORMATION
School		School Phone
School Address
HS Graduation Date Class Rank Approx. HS grade avg. SAT Scores: Verbal Math Composite Date Taken Planned College Major (e.g. business, nursing, etc.)
Guidance Counselor		Phone
ATHLETIC INFORMATION
Honors & Awards
Coach		Coach's Phone
Position Played		Shot Height Weight
Other sports you played or may want to play in college:
Lacrosse camps that you have attended or will attend:
OTHER INFORMATION
Other colleges you're interested in:
Are you requesting financial aid? Yes No
Hobbies or other activities:

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Please forward your lacrosse schedule when it becomes available.
Send to:	Malcolm Chase, Men's Lacrosse Coach, University of Southern Maine Costello Sports Complex, 37 College Ave., Gorham, ME 04038	(207) 228-8589 (Office) (207) 780-5994 (Fax)


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