For '87, ' 88, '89, '90 Birth Years

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Player Profile Information
     Note:
        This information will be printed in the Complete Hockey Showcase scout handbook exactly the way you key it.
        Watch your spelling and use proper upper and lower case.

^{First Name:   Last Name:    Date of Birth:}  (mmddyyy)

^{Address:  City:} AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VA WA DC WV WI WY ^Zip:   

^{Home Phone#:    Cell#:}  

^{Parents Names:     Parent Phone:}  

^E-Mail:       

^{Height:      Weight:      Position:}  Forward Defense Goalie  ^Shot/Glove:  Right Left Catch Right (goalie) Catch Left (goalie)    

^{2005-06 Team:     Games Played:      Goals: Assists: Pts:}  

^{2005-06 Coach:   Phone#:}

^{2005-06 High School:    Phone#:}

^{High School Counselor:    Phone#:}

^{2005-06 Class: Freshman Sophomore Junior Senior    Current Core Course GPA:    Class Rank:}    

^{ACT/SAT Result / or  future test date:    Applied to NCAA Clearing house?  Yes  No}

I agree to have my player profile printed in the Complete Hockey Showcase Scout Handbook.  Yes   No