Middlesex Black Bears Junior/Prep Hockey Recruiting Form
Please fill out all information to the best of your ability. We will be in touch to follow up with you.
Athlete Information
Student-Athlete First Name
Your answer
Student-Athlete Last Name
Your answer
What is your expected high school graduation year?
Your answer
Student-Athlete Cell Number
Your answer
Student-Athlete Email Address
Your answer
Current High School
Your answer
City of home town
Example: North Andover
Your answer
State, Country of home town
Example: MA or Canada
Height
Your answer
Weight
Your answer
Position
Choose all that apply
Required
Shot
For Goalies, Please indicate your CATCHING HAND.
Experience
Teams played for, positions played, highlights, etc.
Your answer
Current Grade Point Average (GPA)
List scale, example: 3.4/4.0
Your answer
SAT, ACT, and/or AP Test Scores
Your answer
Other Academic Information or Honors
Your answer
How did you hear about the Middlesex Black Bears Junior/Prep Hockey program?
Your answer
Parent or Guardian Information
Parent First Name
Your answer
Parent Last Name
Your answer
Parent Email Address
Your answer
Parent Cell Number
Your answer
Additional phone number(s)
Not required
Your answer
Parent's City of home town
Example: North Andover
Your answer
Parent's State or Country of home town
Example: MA or Canada
Father's Occupation
If none, please enter N/A
Your answer
Mother's Occupation
If none, please enter N/A
Your answer
Other Information
Current Coach's First Name
Your answer
Current Coach's Last Name
Your answer
Current Coach's Email
Your answer
Current Coach's Phone Number
Your answer
Additional Coach's First Name
Optional. For students who play for a club team in addition to their school team.
Your answer
Additional Coach's Last Name
Optional. For students who play for a club team in addition to their school team.
Your answer
Additional Coach's Email
Optional. For students who play for a club team in addition to their school team.
Your answer
Home Address
*Please include, House/Apt #, Street Name, City, State & Zip
Your answer
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