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Men's Swimming

The University of Scranton
Department of Athletics

Swim
Questionnaire

 Women's Swimming

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* Required Fields

PERSONAL INFORMATION
* Full Name:
  First:   MI:   Last:
Preferred First Name:  
* Address: 
* City: 
* State:      * Zip: 
E-Mail Address: 
Telephone #:  ( )
Date of Birth:  / /
Graduation Year: 

SWIMMING INFORMATION
(Please list your best times as indicated)

Yards

50

100

200

400

500

1650

Freestyle

Backstroke

Butterfly

Breaststroke

IM

High School Coach: 
Coach's Home Phone #:   ( )
Coach's College (if known): 

Enter Years of Experience by Category: 

High School:

Age Group Swimming:

Y:

USS:

Summer Rec. League:

EDUCATIONAL INFORMATION
Area(s) of Academic Interest: 
High School: 
Guidance Counselor's Name: 
Class Rank:     out of  
College Board Scores:  V:       M: 
Other Extracurricular Interests:
Comments:
Please use this space to provide any other information you feel is significant concerning your swimming and educational plans.)
 

Please feel free to contact us at (570) 941-7571, or by e-mail at: athletics@scranton.edu.


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