PERSONAL INFORMATION First Name Middle Initial Last Name Address City State Zip Email Address Home Phone Number Cell Number Best day/time to call Age Birth Date Height Weight Mother’s Name Occupation Work Phone Father’s Name Occupation Work Phone Address (if different from above) City State Zip Phone Number (if different from above) Sister Age Sister Age Sister Age Sister Age Brother Age Brother Age Brother Age Brother Age List any friends/relatives who attend Rutgers: Hobbies/Interests/Outside Activities Ambitions: 1 2 3 Why are you interested in Rutgers University Swimming and Diving? What other schools are you considering? Date you hope to decide on which University to attend Any other information you would like to share
ACADEMIC INFORMATION High School Currently Attending School Address City State Zip Guidance Counselor’s Name Counselor's Phone Number Graduation Date GPA (4.0 =A) Class Rank Test Scores: SAT M V W Date(s) Taken ACT (Subscore Sum) Date(s) Taken TOEFL (Foreign Students) Date(s) Taken Intended Field of Study
ATHLETIC INFORMATION Number of years trained competitively Number of years trained year round Current USD ClubTeam Coach Phone Number Coach's Address City State Zip High School Team Coach Phone If you have suffered any serious injuries in swimming or have had any operations, please list details :
How much training do you do? Number of practices per week: Hours per practice: Do you participate in a strength and conditioning program? Yes No Does it include lifting weights? Yes No What are your big meets going to be this season ?
