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Student Preferred First Name
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Student Last Name
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Gender*
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Preferred Email
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Student's Birthday
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Student's Current School
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Parent/Guardian Name
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Parent/Guardian Email:
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Address 1
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Address 2
City
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State
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Cell Phone Number
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Boarding or Day Student?*
Boarding
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Desired Year of Entry:
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Applicant for:
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Please Select…
Third Form (9th Grade)
Fourth Form (10th Grade)
Fifth Form (11th Grade)
Sixth Form (12th Grade)
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Swimming and Diving Information
Current school team
Current winter or club team
Are you a registered USA swimmer?
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Please list each event in which you compete and your best performance in that event
*Please indicate whether each distance is meters or yards, and short or long course
Additional Questions/Comments
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