SWIMMING QUESTIONNAIRE

PERSONAL INFORMATION

Name: Phone: Cell:

Home Address (Street,City,State,Zip):

E-mail Address:

Birth Date: Height Weight Age

Graduation date/year 

E-mail Address:

Father's Name Occupation College

Mother's Name Occupation College

Names of friends or relatives who have attended Colorado State University or who live in Colorado

Best times & days(s) to contact you at home by phone (after school or practice-A.M. or P.M.)
Time Zone

ACADEMIC INFORMATION

High School Phone

School Address (Street,City,State,Zip):

H.S. GPA Class Rank No. in Class Intended College Major

Test Scores:ACT Composite SAT Verbal Were test scores sent to Colorado State?Yes No

Have you registered with the NCAA Clearinghouse?
Yes No

ATHLETIC INFORMATION

High School Coach: Phone: Email:

U.S.S. Coach: Phone:

U.S.S. Club: Phone:

Club Address:

Best Times

Free

50 100 200 500 1650

Back

100 200

BRST

100 200

Fly

100 200

I.M.

200 400

Best Relay Splits:

Major Championship Meet Dates:

Special Athletic & Academic Awards & Distinctions