Fields marked with * are mandatory
General

Legal First Name *
*Please enter valid Legal First Name
Middle Name
*Please enter valid Middle 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
Country
*Please enter valid Country
Citizenship
*Please enter valid Citizenship
Date of Birth *
*Please enter valid Date of Birth
Parent/Guardian Contact Info

Parent/Guardian 1 First Name *
*Please enter valid Parent/Guardian 1 First Name
Parent/Guardian 1 Last Name *
*Please enter valid Parent/Guardian 1 Last Name
Parent/Guardian 1 Email *
*Please enter valid Parent/Guardian 1 Email
Parent/Guardian 1 Address *
*Please enter valid Parent/Guardian 1 Address
Parent/Guardian 1 City *
*Please enter valid Parent/Guardian 1 City
Parent/Guardian 1 State *
*Please enter valid Parent/Guardian 1 State
Parent/Guardian 1 Phone Number *
*Please enter valid Parent/Guardian 1 Phone Number
Parent/Guardian 2 First Name *
*Please enter valid Parent/Guardian 2 First Name
Parent/Guardian 2 Last Name *
*Please enter valid Parent/Guardian 2 Last Name
Parent/Guardian 2 Email *
*Please enter valid Parent/Guardian 2 Email
Parent/Guardian 2 Address *
*Please enter valid Parent/Guardian 2 Address
Parent/Guardian 2 City *
*Please enter valid Parent/Guardian 2 City
Parent/Guardian 2 State *
*Please enter valid Parent/Guardian 2 State
Parent/Guardian 2 Phone Number *
*Please enter valid Parent/Guardian 2 Phone Number
Wittenberg Students/Alumni that you know
*Please enter valid Wittenberg Students/Alumni that you know
Academic Information

High School *
School Name
Address1
Address2
Address3
City
State
Zip
Country
CEEB Code
the school is not listed above
*Please enter valid High School
School Phone Number
*Please enter valid School Phone Number
Previous College? *

*Please enter valid Previous College?
Previous College GPA
*Please enter valid Previous College GPA
Degree Earned
*Please enter valid Degree Earned
Previous College Name
*Please enter valid Previous College Name
Graduation Year *
*Please enter valid Graduation Year
Student Type



*Please enter valid Student Type
Entry Term
*Please enter valid Entry Term
Top College Choice 1
*Please enter valid Top College Choice 1
Top College Choice 2
*Please enter valid Top College Choice 2
Top College Choice 3
*Please enter valid Top College Choice 3
Other College Attending
*Please enter valid Other College Attending
Academic Interest 1
*Please enter valid Academic Interest 1
Academic Interest 2
*Please enter valid Academic Interest 2
Academic Interest 3
*Please enter valid Academic Interest 3
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
SAT Total *
*Please enter valid SAT Total
ACT *
*Please enter valid ACT
Academic Honors
*Please enter valid Academic Honors
Athletic Information

Position




*Please enter valid Position
Height *
FeetInch
*Please enter valid Height
Weight *
*Please enter valid Weight
50 Free Time *
*Please enter valid 50 Free Time
100 Free Time *
*Please enter valid 100 Free Time
Are you currently apart of the ODP system? *

*Please enter valid Are you currently apart of the ODP system?
Club Information
*Please enter valid Club Information
Club Team
*Please enter valid Club Team
Club Phone
*Please enter valid Club Phone
Club Website
*Please enter valid Club Website
Club Coach Name
*Please enter valid Club Coach Name
Club Coach Email
*Please enter valid Club Coach Email
Club Coach Title
*Please enter valid Club Coach Title
Club Coach Phone
*Please enter valid Club Coach Phone
HS Team Name
*Please enter valid HS Team Name
HS Coach Name
*Please enter valid HS Coach Name
HS Coach Email
*Please enter valid HS Coach Email
HS Coach Phone Number
*Please enter valid HS Coach Phone Number
Club/High School Competitions
*Please enter valid Club/High School Competitions
Will you compete at the next Junior Olympics? *

*Please enter valid Will you compete at the next Junior Olympics?
Youtube Link
*Please enter valid Youtube Link
Club Schedule
*Please enter valid Club Schedule