Swimming Recruitment Form - Meridian Community College

Personal Information

First Name *

Last Name *

Preferred Name

Country *

Home Address *

Graduation Year *

Date of Birth *

Date Picker

Email address *

Home Phone Number *

Mobile Phone Number *

Facebook

Twitter

Instagram

Parent(s) Information

Parent 1's First Name

Parent 1's Last Name

Parent 1's Address (if Different)

Parent 1's Email

Parent 1's Cell Phone

Parent 2's First Name

Parent 2's Last Name

Parent 2's Address (If Different)

Parent 2's Email

Parent 2's Cell Phone

Academic Information

If any of the questions are not applicable to you please respond with N/A.

School Name *

School Address *

School Phone Number *

School Fax Number *

GPA *

SAT Composite Score *

ACT Composite Score *

TOEFL *

Athletic Information

Height *

Weight *

High School Coach Name *

High School Coach Cell Phone *

High School Coach Email *

Club Coach Name

Club Coach Cell Phone

Club Coach Email

Events

Please list 4 events that you have participated in.

EVENT 1

Event

Date

Date Picker

Time/Mark

1st Place Time/Mark

2nd Place Time/Mark

Date 2nd Place Time/Mark

Date Picker

EVENT 2

Event

Date

Date Picker

Time/Mark

1st Place Time/Mark

2nd Place Time/Mark

Date 2nd Place Time/Mark

Date Picker

EVENT 3

Event

Date

Date Picker

Time/Mark

1st Place Time/Mark

2nd Place Time/Mark

Date 2nd Place Time/Mark

Date Picker

EVENT 4

Event

Date

Date Picker

Time/Mark

1st Place Time/Mark

2nd Place Time/Mark

Date 2nd Place Time/Mark

Date Picker

* required field