Fields marked with * are mandatory
General

Gender *

*Please enter valid Gender
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
City *
*Please enter valid City
State *
*Please enter valid State
Zip *
*Please enter valid Zip
Contact Number *
*Please enter valid Contact Number
Graduation Year *
*Please enter valid Graduation Year
Are you a US Citizen?

*Please enter valid Are you a US Citizen?
Date of Birth *
*Please enter valid Date of Birth
Background

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

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
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
Intended Major
*Please enter valid Intended Major
Other College Choices
*Please enter valid Other College Choices
Athletic

Club Team Name
*Please enter valid Club Team Name
Club Coach Name
*Please enter valid Club Coach Name
Best Times- Please indicate Y and/ or M
*Please enter valid Best Times- Please indicate Y and/ or M
50 Freestyle
*Please enter valid 50 Freestyle
100 Freestyle
*Please enter valid 100 Freestyle
200 Freestyle
*Please enter valid 200 Freestyle
400m/ 500 Free
*Please enter valid 400m/ 500 Free
800m/ 1000 Free
*Please enter valid 800m/ 1000 Free
1500m/ 1650 Free
*Please enter valid 1500m/ 1650 Free
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
50 Fly
*Please enter valid 50 Fly
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
Diving 1m 6 Dives
*Please enter valid Diving 1m 6 Dives
Diving 1m 11 dives
*Please enter valid Diving 1m 11 dives
Diving 3m 6 dives
*Please enter valid Diving 3m 6 dives
Diving 3m 11 dives
*Please enter valid Diving 3m 11 dives
Coach's Name
*Please enter valid Coach's Name
Coach's Number
*Please enter valid Coach's Number
Coach's Email
*Please enter valid Coach's Email