Name: ________________________________________ Nickname/Prefer to be called:___________________________
Address: ______________________________________ City: _______________ State: _____ Zip: ________________
Height: ________ Weight: ________ Soc.Sec.#__________________ Home Phone #: _(____)_____________________
Date of Birth___________________________________ Your email address: _________________________________
Father's Name: __________________________________ Occupation: _______________________________________
Work Phone #: (____)____________________________
Mother's Name: _________________________________ Occupation: _______________________________________
Work Phone #: (____)____________________________

ACADEMIC INFORMATION

High School: ___________________________________________ HS Graduation Date: _________________________
High School Address: __________________________ City: _______________ State: ________ Zip: ______________
Intended Major / School at Vanderbilt You Would Apply To:________________________________________________
Class Rank/Size: ______ / ______ GPA: _______ SAT Total: ___________ Math: _________ Verbal:_______________
ACT Score: ___________ Next Scheduled Date(s) to Take: SAT_________________ ACT________________________

List the other schools to which you will be contacting / applying to:

1. _____________________________ 2. _____________________________ 3. ______________________________

ATHLETICS

Club Team: __________________________________________ Position(s): _________________________________
Club Coach: _____________________________________________________ Phone #: _______________________
HS Coach: ______________________________________________________ Phone #: _______________________
Future Tournaments Participating In: __________________________________________________________________
ODP(note year): _____National Team _____National Pool _____Region Team _____Region Pool _____State Team
Club Individual/Team Honors: ______________________________________________________________________
HS Individual/Team Honors: ________________________________________________________________________


**IMPORTANT**Please send your high school transcripts, ACT or SAT scores, and copy of your current course schedule ASAP. Also, include your upcoming soccer schedule. If you have any questions, please call or email the Vanderbilt Men's Soccer Office at 615-343-8098 or tim.mcclements@vanderbilt.edu

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