LYCOMING COLLEGE

Swimming Questionnaire

General Infomation

Name:

Email:

Sex:

Home Address:

City:

State:

Zip code:

Home Phone:

Cell Phone:

Date of Birth:

Father's Info:

Name:

Occupation:

Bus. Phone:

Mother's Info:

Name:

Occupation:

Bus. Phone:

Academic Infomation

High School

Guidance Counselor:

Academic Interests:

SAT Scores:

Verbal

Math

Written

Date Taken

Class Rank/Total

GPA

Date of Graduation

Athletic Information

Swimming:

Years Participated:

Best Event:

Favorite Event:

Best Times (yd)	Free	Fly	Back	Breast	IM
50
100
200
500 Free/400 IM
1000/1650

Avg. Mid-season yds/Day:

Max. # of Practices/Day:

# of Doubles/Week:

Normal Practice Time - HS:

Normal Practice Time - Club:

HS Season Start/End Dates:

Club Season Start/End Dates:

HS Event Trained For:

Club Event Trained For:

High School Coach Info:

Name: Home Phone: Office Phone:

Club Team:

Club Coach Info:

Name: Club Coach's Phone:

Height:

Weight: (optional)

Awards (Captain, All-Conference, etc.)

Other sports you want to play in college:

Friends/Relatives attending or graduates of Lycoming

What other colleges/universities are you considering?

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