Last Name First Name E-mail Address City State, Zip Code Country Gender Date of Birth Graduation Class Home Phone Cell Phone Father's Name: Father's Email: Father's Cell Phone: College Father Attended: Mother's Name: Mother's Email: Mother's Cell Phone: College Mother Attended: High School: Graduation Year: GPA: SAT Math: SAT Writing: SAT Critical Reading: Composite SAT Score: Composite ACT Score: When did you start 9yh grade? What are the five most important criteria you will use during the college selection process? 1. 2. 3. 4. 5. Club Soccer Coach: Email: Cell: High School Coach: Email: Cell: List Top 5 College Choices: 1. 2. 3. 4. 5. Are you registered with NCAA Clearinghouse? YesNo Are you interested in Road 2 College Soccer Services? YesNo If yes, please enter who to contact along with their number/email: