Your name:
Your e-mail address:
The subject of your message:

Tell us something about yourself:

Last Name:
First Name:
Middle Name:
Nickname:

Address:
City:
State or Country:
Zip Code:
Telephone:

Date of Birth: Mo.
Social Security Number:
Planned College Major:

Tell us something about your family:

Father's Name:
Occupation:
Alma Mater:

Mother's Name:
Occupation:
Alma Mater:

Brothers and Sisters (Name/Age):
Most influential person in your life:
Ethnicity:

Your Academics...

School:
Address:
City:
State or Country:
Zip Code:

SAT Score: Verbal: Math:
ACT Score: Composite:
Academic Honors:
Year/Graduation:
GPA (4.0=A):
Guidance Counselor:
School Phone:

Your Athlethics...

High School Swimming/Diving Coach:
Home Phone:
Club Swimming/Diving Coach:
Home Phone:
Swim/Dive Club:
Address:
City:
State or Country:
Zip Code:

Tell us something about your practices

I average yards in the winter middle season and yards in the summer middle season.
Do you have a weight training and/or dry land strenght program? (please check one)

• Yes
• No

What are your goals in swimming/diving for the next four years?

Please list 6-8 of your best events, specify yards or short or long course meters:

And some more questions...

Have you competed in USA Jr. National? (please check one)

• Yes
• No

Senior Nationals?

• Yes
• No

Your height:

Your weight:

Indicate best performance at the championships (please specify yards or meters):

Indicate any athletic record held, honors received in swimming and other sports:

Do you know anyone who has attended USD? Who?
Do you know anyone presently attending USD? Who?

Why are you interested in USD?

List the top three universities of your choice in order of preference (include USD if

appropriate.)