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Personal Information
First Name: *
Last Name: *
Middle Name:
Preferred Name:
Email: *
Address: *
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: *
Mobile/Alt. Phone:
Gender:
M
F
Place of Birth:
Date of Birth: *
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
Step Sister
Step Brother
Athletic Director
Phone: *
Mobile Phone:
Email:
College Name:
Occupation:
Employer:
Work Phone:
Ext:
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
Step Sister
Step Brother
Athletic Director
Phone: *
Mobile Phone:
Email:
College Name:
Occupation:
Employer:
Work Phone:
Ext:
Athletic Information
Height: *
ft.
in.
Weight: *
Course 1:
SCM
SCY
LCM
Distance 1:
50
100
200
400/500
800/1000
1500/1650
400
500
800
1000
1500
1600
1650
Course 2:
SCM
SCY
LCM
Distance 2:
50
100
200
400/500
800/1000
1500/1650
400
500
800
1000
1500
1600
1650
Course 3:
SCM
SCY
LCM
Distance 3:
50
100
200
400/500
800/1000
1500/1650
400
500
800
1000
1500
1600
1650
Course 4:
SCM
SCY
LCM
Distance 4:
50
100
200
400/500
800/1000
1500/1650
400
500
800
1000
1500
1600
1650
Course 5:
SCM
SCY
LCM
Distance 5:
50
100
200
400/500
800/1000
1500/1650
400
500
800
1000
1500
1600
1650
Course 6:
SCM
SCY
LCM
Distance 6:
50
100
200
400/500
800/1000
1500/1650
400
500
800
1000
1500
1600
1650
Course 7:
SCM
SCY
LCM
Distance 7:
50
100
200
400/500
800/1000
1500/1650
400
500
800
1000
1500
1600
1650
Event 1 Time:
:
:
Stroke 1:
Free
Back
Breast
Fly
IM
Event 2 Time:
:
:
Stroke 2:
Free
Back
Breast
Fly
IM
Event 3 Time:
:
:
Stroke 3:
Free
Back
Breast
Fly
IM
Event 4 Time:
:
:
Stroke 4:
Free
Back
Breast
Fly
IM
Event 5 Time:
:
:
Stroke 5:
Free
Back
Breast
Fly
IM
Event 6 Time:
:
:
Stroke 6:
Free
Back
Breast
Fly
IM
Event 7 Time:
:
:
Stroke 7:
Free
Back
Breast
Fly
IM
Dives working to perform:
Top 1-meter score:
Top 3-meter score:
List 1-meter Optional Dives:
List 3-meter Optional Dives:
Academic Information
SAT:
SAT Math:
SAT Verbal:
ACT:
GPA: *
Class: *
High School
2-Year College
4-Year College
Post-High School, Non-College
Class Rank:
Grad Year: *
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
Registered with Clearinghouse: *
Yes
No
Intended Major:
1st College Preference:
2nd College Preference:
3rd College Preference: