MUHLENBERG COLLEGE SOCCER

2400 CHEW STREET
ALLENTOWN PA   18104
PH. 484 664-3383-Men;
              664-3382-Women
FAX 484 664-3035
Men's Conference Champions
  1972,1989,1994,1995,1997,2005
Men's NCAA Tournament Appearances
  1972,73,89,90,91,92,94,95,96,97,05
Men's ECAC Champions - 1974,75,88
Women's ECAC Champions - 1998,99
SEAN TOPPING, Men's Head Coach
LESLIE BENINTEND, Women's Head Coach

PERSONAL INFORMATION
Male Female
Last Name: First:   Initial:
Year of Graduation:  
Address:
City: State:   Zip:
Home Phone: E-mail:
Birth Date: Ethnicity:
Father's Name: Father's Occupation:
Mother's Name: Mother's Occupation:
Parents are: Married   Divorced   Other
I live with: Both   Mother   Father   Other
Brothers' and Sisters' Names:

SCHOLASTIC INFORMATION
School: School Phone:
School Address:
City: State:   Zip:
Counselor's Name: Counselor's Phone:
Overall G.P.A. Scale Class Rank: /
College Major:
PSAT: V M
SAT: V M E SAT: V M E
ACT:

SOCCER INFORMATION
Height ft in   Weight lbs.
Pos:Preferred 1. 2. Team Captain Yes No
Honors Other Varsity Sports
HS Soccer Coach    Home Phone    Office Phone
Club Soccer Team
Club Soccer Coach Home Phone

GENERAL INFORMATION
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Muhlenberg Student or Alumnus You Know: Name/Relationship