Personal Information Prospect Code: First Name: * Last Name: * Height: * ft.in. Middle Name: Preferred Name: Shoe Size: * Email: * Date of Birth: * Weight: * Address: * State: AL AK AR AS AZ CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY AB AE BC DC MB NB NL NS NT NU ON PE QC SK UN YT PR VI City: * Zip: Country: Phone: * Mobile/Alt. Phone: * Hobbies:   Parent/Guardian Contact Information First Name: * Last Name: * Relationship: * Father Mother Alternate Step Mother Neighbor Uncle Sister Grandfather Guardian Aunt Friend Step Father Brother Grandmother Coach Other Spouse Parent Girlfriend Boyfriend Child Guidance Counselor Wife Cousin Husband Club Director Home Phone: * Mobile Phone: Email: College Attended: Occupation: Employer:   Parent/Guardian Contact Information First Name: * Last Name: * Relationship: * Father Mother Alternate Step Mother Neighbor Uncle Sister Grandfather Guardian Aunt Friend Step Father Brother Grandmother Coach Other Spouse Parent Girlfriend Boyfriend Child Guidance Counselor Wife Cousin Husband Club Director Home Phone: * Mobile Phone: Email: College Attended: Occupation: Employer:   Athletic Information Distance 1: 50 100 200 400/500 800/1000 1500/1650 400 500 800 1000 1500 1600 1650 Stroke 1: Free Back Breast Fly IM Course 1: SCM SCY LCM Event 1 Time: :: Date Acheived 1: Distance 2: 50 100 200 400/500 800/1000 1500/1650 400 500 800 1000 1500 1600 1650 Stroke 2: Free Back Breast Fly IM Course 2: SCM SCY LCM Event 2 Time: :: Date Achieved 2: Distance 3: 50 100 200 400/500 800/1000 1500/1650 400 500 800 1000 1500 1600 1650 Stroke 3: Free Back Breast Fly IM Course 3: SCM SCY LCM Event 3 Time: :: Date Achieved 3: Distance 4: 50 100 200 400/500 800/1000 1500/1650 400 500 800 1000 1500 1600 1650 Stroke 4: Free Back Breast Fly IM Course 4: SCM SCY LCM Event 4 Time: :: Date Achieved 4: Distance 5: 50 100 200 400/500 800/1000 1500/1650 400 500 800 1000 1500 1600 1650 Stroke 5: Free Back Breast Fly IM Course 5: SCM SCY LCM Event 5 Time: :: Date Achieved 5:   Academic Information SAT: SAT Math: SAT Verbal: Class: * High School 2-Year College 4-Year College Post-High School, Non-College GPA: * ACT Composite: Class Rank: Grad Year: * 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Registered with Clearinghouse: * Yes No Clearinghouse ID: Intended Major:   School Information School Name: * Clear District: * Address1: * Address2: City: * State: AL AK AR AS AZ CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY AB AE BC DC MB NB NL NS NT NU ON PE QC SK UN YT PR VI Zip: Country: Phone: Fax: Website: Registrar's First Name: Registrar's Last Name: Registrar's Email: Registrar's Phone: Registrar's Fax:   High School Coach Information Your Coach: Select your head coach My coach isn't in this list, I'll provide the information below First Name: *   Last Name: *   Email: Work Phone: Title: *   Mobile Phone:   Club Team Information Your Coach: Select your head coach My coach isn't in this list, I'll provide the information below Team Name: Clear Coach Name: Address: Coach Email: Address 2: Coach Phone: City: State: AL AK AR AS AZ CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY AB AE BC DC MB NB NL NS NT NU ON PE QC SK UN YT PR VI Zip Code: Country: Website: Fax:

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