Fields marked with * are mandatory
General

First Name *
*Please enter valid First Name
Last Name *
*Please enter valid Last Name
Middle Name
*Please enter valid Middle Name
Preferred Name
*Please enter valid Preferred Name
Email Address *
*Please enter valid Email Address
Home Address 1
*Please enter valid Home Address 1
Home Address 2
*Please enter valid Home Address 2
City
*Please enter valid City
State
*Please enter valid State
Zip
*Please enter valid Zip
Country
*Please enter valid Country
Cell Phone Number *
*Please enter valid Cell Phone Number
Home Phone Number
*Please enter valid Home Phone Number
Best time of day to call
*Please enter valid Best time of day to call
Graduation Year *
*Please enter valid Graduation Year
Gender *

*Please enter valid Gender
Date of Birth
*Please enter valid Date of Birth
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
Academic

High School *
School Name
Address1
Address2
Address3
City
State
Zip
Country
CEEB Code
the school is not listed above
*Please enter valid High School
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 Composite
*Please enter valid ACT Composite
Applied to Urbana University *

*Please enter valid Applied to Urbana University
NCAA Eligibility Center #
*Please enter valid NCAA Eligibility Center #
Academic Honors
*Please enter valid Academic Honors
Top 3 Colleges
*Please enter valid Top 3 Colleges
Intended Major(s)
*Please enter valid Intended Major(s)
Transcripts
*Please enter valid Transcripts
Athletic

Height
FeetInch
*Please enter valid Height
Recruiting Website
*Please enter valid Recruiting Website
Youtube Link
*Please enter valid Youtube Link
High School Coach Name
*Please enter valid High School Coach Name
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
Club Coach Name
*Please enter valid Club Coach Name
Club Coach Phone Number
*Please enter valid Club Coach Phone Number
Club Coach Email
*Please enter valid Club Coach Email
Times In
*Please enter valid Times In
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