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
Home Phone Number
*Please enter valid Home Phone Number
Cell Phone Number
*Please enter valid Cell Phone Number
Best time to call
*Please enter valid Best time to call
Date of Birth
*Please enter valid Date of Birth
Year in School
*Please enter valid Year in School
Gender

*Please enter valid Gender
NCAA Eligibility #
*Please enter valid NCAA Eligibility #
Background

Parent / Guardian #1 Name
*Please enter valid Parent / Guardian #1 Name
Parent / Guardian #1 Phone Number
*Please enter valid Parent / Guardian #1 Phone Number
Parent / Guardian #1 Email Address
*Please enter valid Parent / Guardian #1 Email Address
Parent / Guardian #2 Name
*Please enter valid Parent / Guardian #2 Name
Parent / Guardian #2 Phone Number
*Please enter valid Parent / Guardian #2 Phone Number
Parent / Guardian #2 Email Address
*Please enter valid Parent / Guardian #2 Email Address
Siblings
*Please enter valid Siblings
Athletic

High School/Junior College Coach's Name
*Please enter valid High School/Junior College Coach's Name
High School/Junior College Coach's Phone Number
*Please enter valid High School/Junior College Coach's Phone Number
High School/Junior College Email Address
*Please enter valid High School/Junior College Email Address
Club Team
*Please enter valid Club Team
Club Coach
*Please enter valid Club Coach
Club Coach's Phone Number
*Please enter valid Club Coach's Phone Number
Club Coach's Email Address
*Please enter valid Club Coach's Email Address
Additional Coaching References
*Please enter valid Additional Coaching References
Years in competitive swimming/diving
*Please enter valid Years in competitive swimming/diving
Height
FeetInch
*Please enter valid Height
Weight
*Please enter valid Weight
Other sports participated in
*Please enter valid Other sports participated in
Recruiting Website / Film Link
*Please enter valid Recruiting Website / Film Link
Best Times
*Please enter valid Best Times
50 Free (SCY/LCM)
*Please enter valid 50 Free (SCY/LCM)
100 Free (SCY/LCM)
*Please enter valid 100 Free (SCY/LCM)
200 Free (SCY/LCM)
*Please enter valid 200 Free (SCY/LCM)
400/500 Free (SCY/LCM)
*Please enter valid 400/500 Free (SCY/LCM)
800/1000 Free (SCY/LCM)
*Please enter valid 800/1000 Free (SCY/LCM)
100 Fly (SCY/LCM)
*Please enter valid 100 Fly (SCY/LCM)
200 Fly (SCY/LCM)
*Please enter valid 200 Fly (SCY/LCM)
100 Back (SCY/LCM)
*Please enter valid 100 Back (SCY/LCM)
200 Back (SCY/LCM)
*Please enter valid 200 Back (SCY/LCM)
100 Breast (SCY/LCM)
*Please enter valid 100 Breast (SCY/LCM)
200 Breast (SCY/LCM)
*Please enter valid 200 Breast (SCY/LCM)
200 IM (SCY/LCM)
*Please enter valid 200 IM (SCY/LCM)
400 IM (SCY/LCM)
*Please enter valid 400 IM (SCY/LCM)
1650 SCY / 1500 LCM
*Please enter valid 1650 SCY / 1500 LCM
1 Meter Dive Score (6 Dives)
*Please enter valid 1 Meter Dive Score (6 Dives)
3 Meter Dive Socre (6 Dives)
*Please enter valid 3 Meter Dive Socre (6 Dives)
Academic

Current Institution
*Please enter valid Current Institution
I Have Registered with the Eligibility Center

*Please enter valid I Have Registered with the Eligibility Center
NCAA Eligibility #
*Please enter valid NCAA Eligibility #
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
Guidance Counselor
*Please enter valid Guidance Counselor
Guidance Counselor Phone
*Please enter valid Guidance Counselor Phone
Have you attended another HS?

*Please enter valid Have you attended another HS?
If Yes, Specify
*Please enter valid If Yes, Specify
Have you ever taken classes at another school?



*Please enter valid Have you ever taken classes at another school?
If Yes, Please List
*Please enter valid If Yes, Please List
Class Rank
*Please enter valid Class Rank
out of
*Please enter valid out of
GPA
*Please enter valid GPA
High School Graduation Year
*Please enter valid High School Graduation Year
Academic area of interest
*Please enter valid Academic area of interest
SAT Math
*Please enter valid SAT Math
SAT Verbal
*Please enter valid SAT Verbal
SAT Writing
*Please enter valid SAT Writing
SAT Composite
*Please enter valid SAT Composite
SAT Date Taken
*Please enter valid SAT Date Taken
SAT (File Upload)
*Please enter valid SAT (File Upload)
ACT Composite
*Please enter valid ACT Composite
ACT Date Taken
*Please enter valid ACT Date Taken
ACT (File Upload)
*Please enter valid ACT (File Upload)
Transcripts
*Please enter valid Transcripts
Do you have an admissions application?

*Please enter valid Do you have an admissions application?
Know anyone who has attended UIC?

*Please enter valid Know anyone who has attended UIC?
If so, who?
*Please enter valid If so, who?
Know anyone presently attending UIC?

*Please enter valid Know anyone presently attending UIC?
If so, whom?
*Please enter valid If so, whom?
Why are you interested in UIC?
*Please enter valid Why are you interested in UIC?
List the top 5 universites/schools of your choice
*Please enter valid List the top 5 universites/schools of your choice
#1
*Please enter valid #1
#2
*Please enter valid #2
#3
*Please enter valid #3
#4
*Please enter valid #4
#5
*Please enter valid #5
Academic/Athletic Honors
*Please enter valid Academic/Athletic Honors