Swimming

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Survey for interested student-athletes participating in swimming.

Personal Information

Name *

Address

City

State

Zip / Postal

Country

Telephone

Cell Phone

Email address *

Date of Birth

Parents' Names

Parents' Email Address

Academic Information

High School Name

College Name (if applicable)

High School Phone

High School Graduation Year

Intended Major

What Semester Will You Begin at Eureka?

When Would You Like to Visit Eureka?

High School Grade-Point Average

College Grade-Point Average (if applicable)

Class Rank (x of x)

SAT Score (verbal and math)

ACT Score

Do you plan to take either test again?

Yes No

If yes, which one and when?

Have you ever applied here?

Yes No

Do you intend to apply for financial aid?

Yes No

Academic Honors

Other colleges you are interested in

Athletic Information

Years of College Eligibility Remaining

Other sports

Height

Weight

Current Team (if different from high school)

Letters Won in this sport

Coach's Name

Coach's Phone

Position/Event

Career Statistics(include personal best times):

All-Conference honors in career (first team as a junior, etc.):

Other Athletic Honors in Career (all-state, all-area, etc.):

Other Honors

Team Highlights in career:

* required field