Recruiting Questionnaire

Name:     (first)        (last)        (middle in.)

Street Address:   

City:         State:         Zip Code:      

Home Phone:         Cell Phone:   

Email Address:   

Date of Birth:   

Father's Name:         Occupation:  

Work Phone:   

Mother's Name:         Occupation:  

Work Phone:   

Academic Information:

School Name:   

School Address:   

City:         State:         Zip Code:      

Date of Graduation:   

Guidance Counselor:       Phone:   

Coach:       Phone:   

Class Rank:         Grade Point Average:      S.A.T. - Verbal         Math:   

Academic Honors:


Academic Majors You Are Interested in:   

Do you have an application to Shippensburg University?    Yes No

Have you applied to Shippensburg University?    Yes No   Have you been accepted to Shippensburg?   Yes No

Have you completed and mailed the NCAA Clearinghouse information?   Yes No

If Yes, what date did you submit your information to the NCAA?  

Athletic Information:

Height:         Weight:        Years Swimming in HS:       

League/Conference:   

Age Group/Club/USS Team:   

Age Group/Club/USS Coach:   

Number of Years in Age Group/Club/USS Team:   

Phone Number of Age Group/Club/USS Coach:   

Other Schools You Are Considering:


Other Interests or Hobbies:


Number of Workouts a Day:   AM:      PM:      Weekend:   

Average Yardage Per Day:   AM:      PM:      Weekend:   

Type of Workout You do:     Free Weights     Machines

Number of Weight Workouts Per Week:     Hours per Week  

Type of Dryland Workout You Do:  

Number of Weight Workouts Per Week:       Hours Per Week:  

Best Events (include relay splits):
Event
Time
Date
1. 
2. 
3. 
4. 
5.