Kellogg Community College Women's Soccer Try-Outs Registration Form
KCC's Women's Soccer will be hosting a try-out on Saturday, June 8 (rain date June 9) for 2019 or earlier high school graduates. The form below must be completed to participate, as well as a copy of your physical form and insurance information on file. If you have any questions, please email Head Coach Eieri Jordan-Salivia at or call KCC's Athletic Office at 269-965-4151.
Email address *
First & Last Name *
Address *
City/State/Zip *
Parent/Guardian Name *
Parent/Guardian Phone *
High School *
SAT/ACT Score (optional)
Have you previously attended KCC? *
If yes, please provide your k-ID Number.
What soccer club do you play for? (optional)
Upload a copy of your physical form. (This can be a copy of the the physical currently on file with your school.)
Upload a copy of your insurance information/card. (Front & back)
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