Name _______________________________________________

Preferred Name ________________________________________

Address ______________________________________________

City, State, Zip _________________________________________

Country ______________________________________________

Home Phone _________________ Cell ____________________

E-Mail _______________________________________________

Birthdate _______________ Graduation Year ________________

Twitter ________________________ Facebook Yes No

Instagram _____________________________________________

Siblings (Names & Ages) __________________________________

_____________________________________________________

Special Interest/Hobbies:

Most influential people in your life:

1.____________________________________________________

2. ___________________________________________________

3. ___________________________________________________

What is your connection to Ohio State?

Parent/Guardian #1 Mother Father Other _________

Name ________________________________________________

Street Address (If different) ________________________________

City, State, Zip _________________________________________

E-Mail ________________________________________________

Phone Number _________________________________________

Occupation ____________________________________________

Employer _____________________________________________

College Attended _______________________________________

Parent/Guardian #2 Mother Father Other _________

Name ________________________________________________

Street Address (If different) ________________________________

City, State, Zip _________________________________________

E-Mail ________________________________________________

Phone Number _________________________________________

Occupation ____________________________________________

Employer _____________________________________________

College Attended _______________________________________

PERS

ONAL

INFO

W O M E N ’ S

HOCKEY Nadine Muzerall, Head Coach

Graduation Date ______ / _______

School Name __________________________________________

Address ______________________________________________

City, State, Zip _________________________________________

Counselor’s Name ______________________________________

Counselor’s Email _______________________________________

Counselor’s Phone Number _______________________________

GPA ______________ Class Rank ________ out of __________

SAT ______________ ACT______________

Date of Next ACT/SAT ___________________________________

TOEFL/IELTS (International Only) ____________________________

Eligibility Center ID ______________________________________

Academic Honors/Achievements ___________________________

_____________________________________________________

_____________________________________________________

_____________________________________________________

Academic Interest(s) _____________________________________

_____________________________________________________

_____________________________________________________

_____________________________________________________

What attracts you to Ohio State?

ACAD

EMIC

INFO

@OhioStateWHKY

Club/Organization ______________________________________

Level ________________________________________________

Position ______________________________________________

Jersey Number _________ Height ________ Weight __________

Coach’s Name _________________________________________

Coach’s Address _______________________________________

City, State, Zip _________________________________________

Coach’s Email __________________________________________

Coach’s Phone Number __________________________________

Links to Video (Full URL) __________________________________

_____________________________________________________

Past Season Stats (G/A/P) _________________________________

Athletic Honors/Achievements _____________________________

_____________________________________________________

_____________________________________________________

_____________________________________________________

_____________________________________________________

Other Sports ___________________________________________

_____________________________________________________

Schools you are considering

1.____________________________________________________

2. ___________________________________________________

3. ___________________________________________________

4. ___________________________________________________

ATHL

ETIC

INF

O

Return to Assistant Coach Zoe Hickel, Hickel.6@osu.edu