Swimming & Diving Questionnaire

Personal Information


Full Name
Graduation Year

Preferred First Name
Sex
Male      Female
Date of Birth

Address

City
State
Zip

Email Address

Home Phone
Cell Phone

Preferred method(s) of communication from Westminster Coaching Staff
phone      email      text

Father's Name
Occupation

Mother's Name
Occupation


Swimming and Diving Information


Best Times in Yards

Freestyle
      50       100       200       500       1000       1650

Backstroke
      50       100       200

Breaststroke
      50       100       200

Butterfly
      50       100       200

IM
      200       400

Diving - Best Score (please list dives below)

1m(6) (11)
3m(6) (11)

Dives

Names of Coach(es)

High School
Phone

Club
Phone


Academic Information


High School

Planned College Major
Cumulative GPA

SAT Score (CR)
SAT Score (M)

ACT Score

List other high school activities/sports in which you participate