Please complete the form below if you are interested in being placed on the recruiting list for men's soccer. After your application has been received and reviewed, you MAY be contacted by phone or e-mail by one of the coaching staff to further discuss your interests in Northern Illinois University's soccer program.

Please note the following: Per NCAA regulations, if you are a:
Senior this fall, you can be called after July 1st of this year.
Junior this fall, you can receive written correspondence after September 1st of this year.
Any age/grade younger, we cannot contact you or send anything except camp info or admissions information.

Steve Simmons

Men’s Soccer Coach

Convocation Center 223E

Northern Illinois University

DeKalb, IL 60115

TEL: +1 815 753 1372

FAX: +1 815 753 7700

Graduation Date ______/______/_________

First Name: ________________________________ Last Name:____________________________________

Address: _________________________________________________________________________________

City: ____________________________________________________________________________________

State or Country: _______________________ Zip Code: _______________

Phone Number: ______________________________ Best Time to Call: ____________________________

Date of Birth: ______/______/_________ Height: __________ Weight: __________

Father's Name: _____________________________ Mother's Name: ________________________________

Brothers and Sisters (Name/Age): _____________________________________________________________

_________________________________________________________________________________________

Will you be applying for financial aid? YES NO

Your e-mail address: ________________________________________________________________________

School: ________________________________________ School Phone: ____________________________

SAT/ACT Score: _______________ Overall GPA: _______________ Class Rank: ____________________

Intended College Major: ____________________________________________________________________

Other colleges you are considering: ____________________________________________________________

Best Positions: __________________________________ Player Number: _________

High School Coach: _______________________________ Coach's Phone: ___________________________

Dates of School Season: ______/________/_________ To _______/______/__________

Club Team Name: __________________________________________________________________________

Club Coach: _________________________________ Coach's Phone: _______________________________

Dates of Club Season: ______/________/_________ To _______/______/__________

Olympic Development Program? YES NO

Please Detail Participation: ___________________________________________________________________

Tournaments Attending:

Other Comments or Questions:

Steve Simmons

Men’s Soccer Coach

Convocation Center 223E

Northern Illinois University

DeKalb, IL 60115

TEL: +1 815 753 1372

FAX: +1 815 753 9355