Fields marked with * are mandatory
General

First Name *
*Please enter valid First Name
Last Name *
*Please enter valid Last Name
Email Address
*Please enter valid Email Address
Home Address1
*Please enter valid Home Address1
Home Address2
*Please enter valid Home Address2
City
*Please enter valid City
State
*Please enter valid State
Zip
*Please enter valid Zip
Contact Number
*Please enter valid Contact Number
CellPhone Number
*Please enter valid CellPhone Number
Graduation Year
*Please enter valid Graduation Year
Gender

*Please enter valid Gender
Background

Date of Birth
*Please enter valid Date of Birth
Mother's Name
*Please enter valid Mother's Name
Mother's Phone Number
*Please enter valid Mother's Phone Number
Mother's Email Address
*Please enter valid Mother's Email Address
Father's Name
*Please enter valid Father's Name
Father's Phone Number
*Please enter valid Father's Phone Number
Father's Email Address
*Please enter valid Father's Email Address
Academic

High School/College
School Name
Address1
Address2
Address3
City
State
Zip
Country
CEEB Code
the school is not listed above
*Please enter valid High School/College
Class Rank
*Please enter valid Class Rank
GPA
*Please enter valid GPA
SAT Math
*Please enter valid SAT Math
SAT Verbal
*Please enter valid SAT Verbal
SAT Writing
*Please enter valid SAT Writing
ACT
*Please enter valid ACT
SAT II (i)
*Please enter valid SAT II (i)
SAT II (ii)
*Please enter valid SAT II (ii)
Intended Major
*Please enter valid Intended Major
Applying for Financial Aid?

*Please enter valid Applying for Financial Aid?
Athletic

Name of Club
*Please enter valid Name of Club
Name of Head Club Coach
*Please enter valid Name of Head Club Coach
Head Club Coach Phone Number
*Please enter valid Head Club Coach Phone Number
Event(s)















*Please enter valid Event(s)
Best Times / Scores
*Please enter valid Best Times / Scores
50 Free
*Please enter valid 50 Free
100 Free
*Please enter valid 100 Free
200 Free
*Please enter valid 200 Free
500 Free
*Please enter valid 500 Free
1000 Free
*Please enter valid 1000 Free
1650 Free
*Please enter valid 1650 Free
100 Back
*Please enter valid 100 Back
200 Back
*Please enter valid 200 Back
100 Breast
*Please enter valid 100 Breast
200 Breast
*Please enter valid 200 Breast
100 Fly
*Please enter valid 100 Fly
200 Fly
*Please enter valid 200 Fly
200 IM
*Please enter valid 200 IM
400 IM
*Please enter valid 400 IM
1M Diving
*Please enter valid 1M Diving
3M Diving
*Please enter valid 3M Diving