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Introduction Section
WELCOME TO THE DARTMOUTH MEN'S SOCCER QUESTIONNAIRE
Personal Information
First Name:
Middle Name:
Last Name:
Country:
United States
Anguilla
Antigua
Aruba
Bahamas
Barbados
Belize
Bermuda
Virgin Islands
Canada
Caymans
Clipperton Island
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Greenland
Grenada
Guadeloupe
Guatemala
Haiti
Honduras
Jamaica
Martinique
Mexico
Montserrat
Antilles
Nicaragua
Panama
Saint Barthélemy
Saint Kitts
Saint Lucia
Saint Martin
Saint Pierre
Saint Vincent
Trinidad and Tobago
Caicos Islands
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Falkland Islands
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kazakhstan
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Turkey
Ukraine
United Kingdom
Vatican City
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Canary Islands
Cape Verde
Central African Republic
Chad
Comoros
Ivory Coast
Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guinea-Bissau
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Congo Republic
Reunion
Rwanda
Saint Helena
Sao Tome
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
Tanzania
Togo
Tunisia
Uganda
Western Sahara
Zambia
Zimbabwe
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei
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China
Christmas Island
Cocos Islands
India
Indonesia
Iran
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Israel
Japan
Jordan
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Kuwait
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Laos
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Burma
Nagorno-Karabakh
Nepal
Oman
Pakistan
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Timor-Leste
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United Arab Emirates
Akrotiri and Dhekelia
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Caledonia
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
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Vanuatu
Cook Islands
French Polynesia
Niue
Norfolk Island
Pitcairn Islands
Tokelau
Hong Kong
Address Type:
Billing
Business
Campus
Home
Mailing
Physical
Shipping
Street Address:
City:
State:
---Select State---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Mariana Islands
Minor Out. Is.
No State
Armed Forces Pacific
Zip:
Grad Year:
---Grad Year---
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
Date of Birth:
Email Address:
Home Phone:
Mobile Number:
FaceBook:
Twitter:
@
Instagram:
@
Parent(s) Information
Parent 1's First Name:
Parent 1's Last Name:
Parent 1's Gender:
Male
Female
Another Legal Sex
Not Available
Parent 1's Address (If Different):
Parent 1's City:
Parent 1's State:
---Select State---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Mariana Islands
Minor Out. Is.
No State
Armed Forces Pacific
Parent 1's Zip:
Parent 1's Occupation:
Parent 1's Email Address:
Parent 1's Cell Phone:
Parent 1's Business Ph.:
Parent 1's College:
Siblings (Names & Age):
Parent 2's First Name:
Parent 2's Last Name:
Parent 2's Gender:
Male
Female
Another Legal Sex
Not Available
Parent 2's Address (If Different):
Parent 2's City:
Parent 2's State:
---Select State---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Mariana Islands
Minor Out. Is.
No State
Armed Forces Pacific
Parent 2's Zip:
Parent 2's Occupation:
Parent 2's Email Address:
Parent 2's Cell Phone:
Parent 2's Business Ph.:
Parent 2's College:
Academic Information
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School Name:
School Address:
School City:
School State:
---Select State---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Mariana Islands
Minor Out. Is.
No State
Armed Forces Pacific
School Zip:
School Phone#:
School Fax#:
Counselor's First Name:
Counselor's Last Name:
GPA:
SAT Test Date:
SAT Reading:
SAT Math:
SAT Writing:
SAT Composite:
ACT Test Date:
ACT Sum Score:
ACT Composite:
TOEFL:
Class Rank:
Out Of
Intended Major:
Have you Joined the Eligibility Center?
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No
Eligibility ID:
Club Information
Club Name:
Club City:
Club State:
---Select State---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Mariana Islands
Minor Out. Is.
No State
Armed Forces Pacific
Club Coach:
Club Coach Cell:
Club Coach Email:
Athletic Information
Height
Select
8' 11"
8' 10"
8' 9"
8' 8"
8' 7"
8' 6"
8' 5"
8' 4"
8' 3"
8' 2"
8' 1"
8' 0"
7' 11"
7' 10"
7' 9"
7' 8"
7' 7"
7' 6"
7' 5"
7' 4"
7' 3"
7' 2"
7' 1"
7' 0"
6' 11"
6' 10"
6' 9"
6' 8"
6' 7"
6' 6"
6' 5"
6' 4"
6' 3"
6' 2"
6' 1"
6' 0"
5' 11"
5' 10"
5' 9"
5' 8"
5' 7"
5' 6"
5' 5"
5' 4"
5' 3"
5' 2"
5' 1"
5' 0"
4' 11"
4' 10"
4' 9"
4' 8"
4' 7"
4' 6"
4' 5"
4' 4"
4' 3"
4' 2"
4' 1"
4' 0"
Weight (in lbs.)
Jersey #
Events
US Academy Summer Showcase
US Academy WInter Showcase
US Academy Playoffs
Jefferson Cup
Disney Showcase
College Cup Showcase
Blue Chip Showcase
CASL Showcase
PDA Showcase
Surf Cup
USYSA Region I Finals
USYSA Region II Finals
USYSA Region III Finals
USYSA Region IV Finals
USYSA National Finals
Potomac
Nomads
FC Dallas Cup
Dallas Cup
Northern California Spring Showcase
Cal North Presidents Cup
Positions
Soccer
Goalkeeper(GK)
Left Back(LB)
Center Back(CB)
Right Back(RB)
Defense(DEF)
Right Mid(RM)
Center Mid(CM)
Left Mid(LM)
Midfield(MID)
Forward(FWD)
Soccer
Other Questions
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Additional Tournament or Showcases not listed?
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School Name:
OR :
State:
---State---
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Mariana Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
No State
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
City:
Club Name:
Team Name:
Coach Last Name:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Mariana Islands
Minor Out. Is.
No State
Armed Forces Pacific
City:
Club Name:
Team Name:
Club State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Mariana Islands
Minor Out. Is.
No State
Armed Forces Pacific
Club Coach First Name:
Club Coach Last Name:
Club Coach Email:
Club Coach Mobile:
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