CCSU Swimming and Diving Prospective Student-Athlete Questionnaire

Thank you for your interest in Central Connecticut swimming and diving.  Please fill out the questions below.

First Name:
Last Name:
Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Email:
Grad Year:
DOB (mm/dd/yyyy):
High School:
City & State High School is Located in:
Grade Point Average:
Class Rank:
S.A.T. (Yes/No):
S.A.T. Score:
S.A.T. Writing:
S.A.T. Reading:
S.A.T. Math:
ACT (Yes/No):
ACT Score:
Clearinghouse (Yes/No):
Clearinghouse ID:
Events and Personal Best Times:
Height:
Weight:
Mother's Name:
Father's Name:
Club Team:
Club Team Coach:
Club Coach Email:
Club Coach Phone:
Yardage/Practice:
Practices/Week:
Months Swimming/Year:
High School Coach:
High School Coach Email:
High School Coach Phone:
Meets Attending:
Other Interests: