This form is used to obtain information about Alumni Players and their hockey playing experience with the Penn Hockey Club.  The information you fill-in  may be published in the souvenir program and on the website.    

***Do not put anything on this form that you do not want published.***

Survey Contents:

Personal Information
Player Name (First and Last)
Hockey Nickname
E-mail
Address:
City, ST, Zip
Home Phone
Work Phone
Cell Phone
High School Attended
Year you Graduated
Hockey with PENN
Position(s) played		Center Defense Forward Goalie Wing
Left/Right Shot		Left Right Both
Years Played  for PENN		Year Start Year End
Who Was your Head Coach(s)?
Who Was your Assistant Coach(s)?
		*Note: Listing all your coaches will help us build the club's history for the website.
Jersey #
Years Playing Hockey
Years Played for PENN		1 2 3 4 5
Most Memorable Penn Hockey Experience:  Advice to Younger Players:
Hockey after PENN:
College Hockey Team
College Hockey Website
Years Played for College
Other  Hockey Team
Type of Other Hockey Team		Junior A Junior B AAA Pro Other   (If Other, list type)
Other Hockey Website
Years Played for Other Team
		Use this field to list other information about hockey you have played since PENN
Coaching/Refereeing after PENN:
	Highest Coaching Level	Level 1 (Initiation) Level II (Associate) Level III (Intermediate) Level IV (Advanced) Level V (Masters) (USA Hockey Certifications)
	Years Coaching
Type of Team Coached (To select more than one, hold Ctrl  key while making selection)		High School - Boys High School - Girls Bantam Pee Wee Squirts Mites College Junior A Junior B AAA Pro Other   (If Other, list type)
	Highest Refereeing Level	Level 1 (Initiation) Level II (Associate) Level III (Intermediate) Level IV (Advanced) Level V (Masters) (USA Hockey Certifications)
	Years Refereeing
Life Outside of Hockey
The following four questions pertains to your personal life.
Married?		Yes No
Children?		Yes No      How many?
Employer
Occupation

Would you be interested in an Alumni Hockey Game?

Yes                    
No                    

Would you like to be included on the Penn Hockey mailing list?

Yes                    
No                    

How do you like the team's website?

Pretty cool!                     
Doesn't really matter to me.
Don't like the website at all. 

Feel free to give me suggestions for things you'd like to see on the website:

If you have any team photos, history, stats, etc. please send an email to alumni@pennhockey.org so we can build the club's history on the website.