EmailMe Form - SUMMER 2022 TOPP COLLEGE ID CLINIC

Name *

First Last

Event *

Richmond, BC (Thursday, June 30/Friday, July 1)

Edmonton, AB (Monday, July 4/Tuesday, July 5)

Calgary, AB (Thursday, July 7/Friday, July 8)

Welland, ON (Monday, July 11/Tuesday, July 12)

Ottawa, ON (Thursday, July 14/Friday, July 15)

Gender *

Boys

Girls

High School Graduating Year *

Date of Birth (ex November 25, 2004) *

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Player Email *

Player Phone Number *

### - ### - ####

Parent Email *

Parent Phone Number *

### - ### - ####

High School Name *

High School City and Province/State (ex. Oakville, Ontario) *

GPA or Report Card Average (Grade 8-present)- Ex 3.6 GPA or 90% Average *

SAT Score (just write N/A if you haven't taken them) *

ACT Score (just write N/A if you haven't taken them) *

City, State/Province, Where Club Team is Based (ex. Vancouver, BC) *

Club Name and Age Group *

City/Province Where Club is Located (ex Calgary, AB) *

Club Team Coach' Name *

Club Coach's Contact Email *

Primary Position *

Secondary Position *

Primary Foot *

Right Footed

Left Footed

Top 5 Schools You Are Interested In *

Where You Are Interested In Going To School *

Canada (U Sport/CCAA)

US (NCAA/NAIA)

Open to Both US and Canada

Emergency Contact Name *

First Last

Emergency Contact Relationship to Player (ex. Mother) *

Emergency Contact Phone Number *

### - ### - ####

I have a video/highlight reel available for coaches *

Yes

No

Twitter Username @

Instagram Username @

Player Evaluation (Detailed Written Evaluation of Strengths and Weaknesses by University Coaches) - SOLD OUT

$99

Video of 11v11 Game Play (2 Games)

$65

NOTES IF APPLICABLE (Any Credits etc)