Football Intake Form
Name
First Name
Last Name
Email for receipt.
example@example.com
Is the student a US citizen or Legal Permanent Resident? *
Yes
No
Main Language spoken at home
Other languages spoken at home
Dominant foot
Primary Position(s)
Current Football Club
If you have attended more than one high school, please list the high schools and dates attended.
Birthday
-
Month
-
Day
Year
Date
Please list current and previous teams with current football club:
Include dates
Please list previous clubs and teams:
Include dates
What are your football goals?
What is your favorite thing about the game of football?
What professional soccer player do you feel you play the most like?
How many hours do you train a week?
Please use this space to let us know anything else about you.
Submit
Should be Empty: