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Panther C Symbol Men's Soccer


Head Coach: Ben Cooper  
Assistant Coach: Juan Fresquez  
Men's Soccer Office: 909/652-6303 Fax: 909/652-6295  


Prospect Questionnaire

The information provided in this form will be sent to the Chaffey College soccer office. Additional questions should be directed to the soccer office at 909/652-6303, or e-mail to bencoop@msn.com. Thank you!

 

Last Name
  First Name
  Home Phone Number
  E-Mail Address
  Required
  Street Address
  City
  State
  Zip Code
   
  Birthplace (City and State)
  Birth Date
  Height
  Weight
   
  Planned Major
   
  High School
  High School Street Address
  City
  State
  Soccer Coach
  Soccer Coach Phone
   
  Graduation Month/Year
  PSAT Score
  SAT Score
  ACT Score
   
  Previous College Attended
  Street Address
  City
  State
  Soccer Coach
  Soccer Coach Phone
   
 
Positions Played:
 
 
 
   




   
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