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Southwestern's Men's Soccer Team
Men's Soccer Inquiry
Fields marked with an * are required.
First Name *
Last Name *
Address *
City *
State *
Zip *
Phone *
Other Phone
Fax
Email Address
*(Please enter "none" if you don't have one.)
MUST be a VALID email address. Do not put in multiple addresses.
High School
Grade
GPA *
High School Coach Name
Coach's Phone #
Date of Birth *
Height *
Weight *
Position *
Main kicking foot
Soccer Honors
What position would you like to try
Interest in Attending Southwestern 1-5
Career Interest
Please use this space for comments or questions that you may have.
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