SOCCER - FUTSAL QUESTIONNAIRE
Email
Secondary Email
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PERSONAL INFORMATION
Email address *
Full Name *
Address *
City *
Province/State *
Postal Code/Zip Code *
Country *
Phone Number *
Height *
SPORT SPECIFIC INFORMATION
Sport of Choice *
Women's Soccer
Men's Soccer
Women's Futsal
Men's Futsal
Please fill in the box for your sport(s). Include highlights such as points per game, provincial team experience, times in races, awards won, events you competed in, etc. *
Highlight Reel
Please provide a video highlight of your sport. You may copy and paste your YouTube link in the text box below.
List any Clubs or Academies you participated in.
HIGH SCHOOL INFORMATION
High School Name *
What grade are you currently in? *
Coach's Name *
Coach's Phone Number *
Coach's Email *
OTHER INFORMATION
What Lakeland program(s) interest you *
Why are in interested in attending Lakeland *
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