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
Country
*Please enter valid Country
Home Phone Number *
*Please enter valid Home Phone Number
Cell Phone Number
*Please enter valid Cell Phone Number
Date of Birth
*Please enter valid Date of Birth
NickName
*Please enter valid NickName
Gender

*Please enter valid Gender
Student Type *

*Please enter valid Student Type
Background

Mother's Name
*Please enter valid Mother's Name
Mother's Occupation
*Please enter valid Mother's Occupation
Father's Name
*Please enter valid Father's Name
Father's Occupation
*Please enter valid Father's Occupation
Academic

Graduation Year *
*Please enter valid Graduation Year
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
Counselor's Name
*Please enter valid Counselor's Name
Class Rank
*Please enter valid Class Rank
GPA
*Please enter valid GPA
SAT Math
*Please enter valid SAT Math
SAT Total
*Please enter valid SAT Total
Date of Completion SAT
*Please enter valid Date of Completion SAT
ACT
*Please enter valid ACT
Date of Completion ACT
*Please enter valid Date of Completion ACT
Academic Honors
*Please enter valid Academic Honors
Intended Major
*Please enter valid Intended Major
Other College Choices
*Please enter valid Other College Choices
Has Applied (yes/no)

*Please enter valid Has Applied (yes/no)
Athletic

Best Times
*Please enter valid Best Times
50 yrd. Freestyle
*Please enter valid 50 yrd. Freestyle
100 yrd. Freestyle
*Please enter valid 100 yrd. Freestyle
200 yrd. Freestyle
*Please enter valid 200 yrd. Freestyle
500 yrd. Freestyle
*Please enter valid 500 yrd. Freestyle
1000 yrd. Freestyle
*Please enter valid 1000 yrd. Freestyle
1650 yrd. Freestyle
*Please enter valid 1650 yrd. Freestyle
200 yrd. IM
*Please enter valid 200 yrd. IM
400 yrd. IM
*Please enter valid 400 yrd. IM
100 yrd Butterfly
*Please enter valid 100 yrd Butterfly
200 yrd Butterfly
*Please enter valid 200 yrd Butterfly
100 yrd Breaststroke
*Please enter valid 100 yrd Breaststroke
200 yrd Breaststroke
*Please enter valid 200 yrd Breaststroke
100 yrd Backstroke
*Please enter valid 100 yrd Backstroke
200 yrd Backstroke
*Please enter valid 200 yrd Backstroke
50 meter Freestyle
*Please enter valid 50 meter Freestyle
100 meter Freestyle
*Please enter valid 100 meter Freestyle
200 meter Freestyle
*Please enter valid 200 meter Freestyle
400 meter Freestyle
*Please enter valid 400 meter Freestyle
800 meter Freestyle
*Please enter valid 800 meter Freestyle
1500 meter Freestyle
*Please enter valid 1500 meter Freestyle
200 meter IM
*Please enter valid 200 meter IM
400 meter IM
*Please enter valid 400 meter IM
100 meter Butterfly
*Please enter valid 100 meter Butterfly
200 meter Butterfly
*Please enter valid 200 meter Butterfly
100 meter Breaststroke
*Please enter valid 100 meter Breaststroke
200 meter Breaststroke
*Please enter valid 200 meter Breaststroke
100 meter Backstroke
*Please enter valid 100 meter Backstroke
200 meter Backstroke
*Please enter valid 200 meter Backstroke
Divers High Scores
*Please enter valid Divers High Scores
1-Meter board (6-dive) score
*Please enter valid 1-Meter board (6-dive) score
1-Meter board (11-dive) score
*Please enter valid 1-Meter board (11-dive) score
3-Meter board (6-dive) score
*Please enter valid 3-Meter board (6-dive) score
3-Meter board (11-dive) score
*Please enter valid 3-Meter board (11-dive) score
Please list all dives you have completed
*Please enter valid Please list all dives you have completed
Dive 1
*Please enter valid Dive 1
Dive 2
*Please enter valid Dive 2
Dive 3
*Please enter valid Dive 3
Dive 4
*Please enter valid Dive 4
Dive 5
*Please enter valid Dive 5
Dive 6
*Please enter valid Dive 6
Dive 7
*Please enter valid Dive 7
Dive 8
*Please enter valid Dive 8
Dive 9
*Please enter valid Dive 9
Dive 10
*Please enter valid Dive 10
Dive 11
*Please enter valid Dive 11
Dive 12
*Please enter valid Dive 12