Combine Form :: USHL.COM

If you are interested in attending a USHL Combine, please complete and submit this form. For purposes of a quality evaluation process for the coaches, only the best players in the world at their respective age groups will be invited.

Please provide the information requested below

Name First Name Middle Initial Last Name

Personal Information Date of Birth Height Weight

Are you a US Citizen? Yes No

If no, please list your native country

Contact Information E-Mail Address Street Address City State ZIP Code Home Phone Cell Phone

Family Information

Parents Father's Name Father's Occupation

Is your father a college graduate? Yes No

If yes, from what university? Mother's Name Mother's Occupation

Is your mother a college graduate? Yes No

If yes, from what university?

Siblings Please list any brothers or sisters and their ages

Hockey Information Current Team Current League Position(s) Best or Preferred

Shot: Right Left

Team Website Coach's Name Coach's Phone Number

Teams you have played with the last three years: Statistics / (Goalies)

Year	Team	GP	G/(GAA)	A/(SV%)	PIMS/(SO)
Year	Team	GP	G/(GAA)	A/(SV%)	PIMS/(SO)
Year	Team	GP	G/(GAA)	A/(SV%)	PIMS/(SO)

Other sports you play or played Honors / Awards received in all sports

Gauge your level of interest in playing for a USHL team next season
Some Maybe Most Likely Definitely

Do you have a family advisor? Yes No

If yes, which company/agency? Family advisor's name Family advisor's phone number

Are you on the protected list of a Canadian Major Junior team? Yes No

If yes, which one?

Academic Information Name of High School What grade are you in? Year of Graduation Guidance Counselor Counselor's Phone Number Your Grade Point Average or Percentage Your Class Rank ACT Composite Score