Wittenberg University —Swimming Questionnaire

Student Athlete Questionnaire: Swimming and Diving

Personal Information:

First Name:*
Middle Name:
Last Name:*
Preferred Name:
Birthdate:*	Month
Gender:	Male Female
Are you:*	a U.S Citizen/Permanent Resident an International
Citizenship:

Contact Information:

	Home Address:
Address Line1:*
Address Line2:
City:*
State:*
Zip:*
Country if outside U.S.
Home Phone:
Cell Phone:
Your E-mail:

Academic Information:

Areas of Academic Interest:

Top 3 College Choices:
1)	2)	3)

G. P. A.		Class Rank:		Class Size:
SAT (V):		SAT (M):		ACT(composite):

High School Information:

High School Name:

High School Phone:

Grad Year:

High School Coach:

High School Coach Phone:

Father’s Name:		Wittenberg alumnus?	Yes No
Mother’s Name:		Wittenberg alumnus?	Yes No

Wittenberg students/alumni that you know:

Financial Information:

Do you plan to apply for financial aid?

Financial aid applicants must complete the Free Application for Federal Student Aid (FAFSA). A Financial Assistance Estimator is also available through the Office of Admission.

Has the FAFSA been completed? Wittenberg's FAFSA code is: 003143

Please send: Viewbook Application Financial Aid Information

Swimming Experience/Player Profile

Height

Swimming Event Information:

Event	Best Time (In Season)	Best Time (tapered)

Diving Event Information

Diving List 1-M	Best Score

Diving List 3-M	Best Score

Preferred Events:

Coach Information:

USS/YMCA Coach	Team	Phone

Please describe your current training schedule:

Extra Curricular Activities: Please list any extra curricular activities you are involved in.

Swimming & Diving honors: Please list individual or team honors.

Personal assessment: Please list your strengths and areas needing improvement.

Wittenberg swimming: Please list any questions about our swimming program.

Campus Visitation

Have you visited the Wittenberg campus?

Yes	No	If so, When?

Do you plan to visit Wittenberg in the near future?

Yes	No	If so, When?

Would you like to meet with the swimming coach during your campus visit?

Yes	No

Thank you for filling out this questionnaire and helping us to learn more about you!