NOTE:This form is not an official university application.
This form will be used by the swimming coaching staff to help determine prospective student-athletes.
NCAA rules prohibit coaches from contacting freshman and sophomores in high school.

Personal Information

Last Name First Name Middle I.

Social Security Number

Country Sex (m/f)

Street Address

City , State Zip

Home Phone # Email Address

Date of Birth (mo/day/yr) Date of Grad (mo/yr)

Height (ft/in) Weight (lbs)

Ethnic Background (optional)

Non-Athletic Activities

Student Body Officer Editor, School Publication Field of Study
Class President National Honor Society Other

Academic Information

Class Rank out of G.P.A.

Test Scores:

SAT: Date (mo/day/yr) Verbal Math
ACT: Date (mo/day/yr) Composite  
Achievement
Scores: 		   

High School Name Year in School (fr/so/ju/sr)

Street

City , State Zip Phone

Guidance Counselor

 

Swimming Information

Swimmers:

Please Enter your Best Times:
  SCY LCM   SCY LCM
50 Free 400 IM
100 Free 100 Fly
200 Free 200 Fly
500/400 Free 100 Back
1000/800 Free 200 Back
1650/1500 Free 100 Breast
200 IM 200 Breast


Divers:
Please list Dives and Scores
USS Coach:
Club Name:
Address:
City:   State:   Zip:

Club Phone:

High School Coach: Phone:

Interest Level

Other Colleges of Interest

Do you intend to apply for financial assistance to attend college (optional). Yes No

Names of Yale students or alumni who you know:

Anything else you would like us to Know:

Questions? Comments? Email the webmaster.