Please Fill Out the Following Information and Coach Lisa Petruccelli Will Get Back to You

If your browser does not support forms, you may call the Athletics Office at 315 267-3135. 


Name: 
Address:
Street or P.O. Box: 
City & State:
ZIP Code:
Phone Number (with area code): 
E-mail address: 
Date of Birth: 
Parents' Names: 


High School Students

High School: 
Location of School: 
Current Year in School (Fr., Soph., Jr., Sr.):
Varsity Sports Played (include No. of years for each):
Awards (all-star teams, team awards, all-star games, etc.) 
Grade Point Average: 
SAT Scores: Verbal Math 
ACT Score: 
Anticipated Major: 


Transfer Students

Last School Attended: 
Location of School: 
Last Year of Study Completed (Fr., Soph., Jr., Sr.):
Sports Played (include No. of years for each):
Awards (all-star teams, team awards, all-star games, etc.) 
Grade Point Average: 
Major: 
Anticipated Major at Potsdam: 


Athletic Information

Years of Soccer Experience: 
Positions Played: 
Height: 
Weight: 
Statistics: 
Coach's Name: 
Coach's Phone Number: 
Other Teams, Leagues, Camps Participated in: