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
Date of Birth
*Please enter valid Date of Birth
Gender (Male/Female)
*Please enter valid Gender (Male/Female)
Background

Mother's Name
*Please enter valid Mother's Name
Mother's Phone
*Please enter valid Mother's Phone
Mother's Email
*Please enter valid Mother's Email
Father's Name
*Please enter valid Father's Name
Father's Phone
*Please enter valid Father's Phone
Father's Email
*Please enter valid Father's Email
Siblings
*Please enter valid Siblings
Academic

Graduation Year
*Please enter valid Graduation Year
High School
School Name
Address1
Address2
Address3
City
State
Zip
Country
CEEB Code
the school is not listed above
*Please enter valid High School
Counselor's Name
*Please enter valid Counselor's Name
Counselor's Phone
*Please enter valid Counselor's Phone
Counselor's Email
*Please enter valid Counselor's Email
Class Rank
*Please enter valid Class Rank
GPA
*Please enter valid GPA
SAT Math
*Please enter valid SAT Math
SAT Critical Reading
*Please enter valid SAT Critical Reading
SAT Writing
*Please enter valid SAT Writing
SAT Total
*Please enter valid SAT Total
ACT
*Please enter valid ACT
SAT II (i)
*Please enter valid SAT II (i)
SAT II (ii)
*Please enter valid SAT II (ii)
Academic Honors
*Please enter valid Academic Honors
Intended Major
*Please enter valid Intended Major
Other College Choices
*Please enter valid Other College Choices
NCAA Eligibility #
*Please enter valid NCAA Eligibility #
Athletic

Height
FeetInch
*Please enter valid Height
Weight
*Please enter valid Weight
Number of years of competitve swimming
*Please enter valid Number of years of competitve swimming
Number of months per year spent swimming
*Please enter valid Number of months per year spent swimming
Number of practices per week
*Please enter valid Number of practices per week
Hours of practice per day
*Please enter valid Hours of practice per day
Name of Club Coach
*Please enter valid Name of Club Coach
Club Coach Phone Number
*Please enter valid Club Coach Phone Number
Club Coach Email Address
*Please enter valid Club Coach Email Address
Name of Club Team
*Please enter valid Name of Club Team
Name of High School Coach
*Please enter valid Name of High School Coach
High School Coach Phone Number
*Please enter valid High School Coach Phone Number
High School Coach Email Address
*Please enter valid High School Coach Email Address
Event(s)

*Please enter valid Event(s)
Best Times (please indicate Y-YDS, S-SCM, L-LCM)
*Please enter valid Best Times (please indicate Y-YDS, S-SCM, L-LCM)
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
1000/800 Free
*Please enter valid 1000/800 Free
1650 Free
*Please enter valid 1650 Free
50 Fly
*Please enter valid 50 Fly
100 Fly
*Please enter valid 100 Fly
200 Fly
*Please enter valid 200 Fly
50 Back
*Please enter valid 50 Back
100 Back
*Please enter valid 100 Back
200 Back
*Please enter valid 200 Back
50 Breast
*Please enter valid 50 Breast
100 Breast
*Please enter valid 100 Breast
200 Breast
*Please enter valid 200 Breast
200 IM
*Please enter valid 200 IM
400 IM
*Please enter valid 400 IM
1M
*Please enter valid 1M
3M
*Please enter valid 3M