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Home
About Us
Our Vision
Our History
Billet Families
Team
Hockey and Coaching Staff
Off-Ice Staff
Premier Roster
Premier Schedule
Elite Roster
Elite Schedule
Players Advanced
Prospective Player Form
News & Events
Store
Merchandise
Tickets
My Cart
Contact Us
Sponsors
Prospective Player Form
Please fill out all areas of the form if you are interested in playing for Elmira!
Elmira Impact Prospective Player Form
First Name:
*
Last Name:
*
Birth Year (4 digits)
*
Position:
*
Last Team:
*
Your Cell Phone:
*
Your Email Address:
*
Grade Point Average (GPA) on a 4.0 scale:
*
ACT/SAT Scores if taken:
Shoot:
*
Left
Right
Goals Scored in how many games with last team:
*
Assists Made in how many games with last team:
*
Penalty Minutes in how many games with last team:
*
Save Percentage with last team: (If Applicable):
Height:
*
Weight:
*
Name of Last Coach:
*
Phone Number of Last Coach:
*
Goals/Aspirations:
*
What makes you interested in playing in Elmira?
If you are human, leave this field blank.
Submit
Home
About Us
Our Vision
Our History
Billet Families
Team
Hockey and Coaching Staff
Off-Ice Staff
Premier Roster
Premier Schedule
Elite Roster
Elite Schedule
Players Advanced
Prospective Player Form
News & Events
Store
Merchandise
Tickets
My Cart
Contact Us
Sponsors