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
E-Mail Address		Home Phone
Mailing Address
City, State, Zip
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
ATHLETIC INFORMATION
Hockey Teams Played For
Coach		Coach's Phone
Position Played		Shot Height Weight
Other sports you may want to play in college:
Upcoming tournaments you will participate in:
OTHER INFORMATION
Other colleges you're interested in:
Are you requesting financial aid? Yes No
Hobbies, activities, or athletic awards/honors won:

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Please forward your ice hockey schedule when it becomes available.
Send to:	John Lauziere, Women's Ice Hockey Coach University of Southern Maine Costello Sports Complex, 37 College Avenue Gorham, ME 04038	(207) 780-5996 (Office) (207) 780-5182 (Fax) jlauziere@usm.maine.edu (email)


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