SIU Swimming Recruiting Questionnaire
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SALEM INTERNATIONAL UNIVERSITY – Swimming Recruiting Questionnaire Name:_______________________________________________ Male/Female ______ Last First Middle Mailing Address: _____________________________________________________ City ___________State/Prov. _______ Country ___________________Postal Code:________________ Telephone ( ) ___________E-mail Address ______________________________________________ High School: _______________ Graduation Date: __________ High School Address: ___________________________________________________ Junior College/College or University: _________________ Semesters: ___Units:___ SS # ______________D.O.B. _______ (HS/College) GPA. _______Class Rank ____ SAT Scores: Verbal ____Math ____ ACT Scores: Eng____ Math___ Reading___ Science____ Comp___ Are You Registered with NCAA Initial Eligibility Center (Clearinghouse)? (Y/N) ______ Intended College Major: _____________________________ Anticipated Start Date:__________ Other Colleges that you are applying to: ________________________________________ Parents/Guardians Names and Occupations: _____________________________________ ____________________________________ Number of Siblings (ages): ___________________________________________________ Water Polo Specific Information: HT. ____ WT. _____ Dominant Hand: _____Ambidextrous? (Y/N) ______ H.S. Water Polo Coach _____________________Phone # ________________________ Club Water Polo Coach _____________________Phone # ______________________ Positions Played: __________________________ How many years playing water polo?____________ Speed: 50 Freestyle Time (y/m): ____ 100 Freestyle Time (y/m):____ Swimming Specific Information: Swim Year Round? (Y/N) ____ How many years? ______ SWIMMING TIMES: FREE FLY BACK BREAST IM 50 XXXX 100 200 400 XXXX XXXX XXXX XXXX 500 XXXX XXXX XXXX XXXX OTHER Please Complete and Return to: Curt Altschul - Men’s & Women’s Swimming & Water Polo Coach Salem International University 223 West Main Street Salem, West Virginia 26426 304-326-1475
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Salem International University
Transcript of SIU Swimming Recruiting Questionnaire
SALEM INTERNATIONAL UNIVERSITY – Swimming
Recruiting Questionnaire
Name:_______________________________________________ Male/Female ______
Last First Middle
Mailing Address: _____________________________________________________
City ___________State/Prov. _______ Country ___________________Postal Code:________________
Telephone ( ) ___________E-mail Address ______________________________________________
High School: _______________ Graduation Date: __________
High School Address: ___________________________________________________
Junior College/College or University: _________________ Semesters: ___Units:___
SS # ______________D.O.B. _______ (HS/College)
GPA. _______Class Rank ____
SAT Scores: Verbal ____Math ____
ACT Scores: Eng____ Math___ Reading___ Science____ Comp___
Are You Registered with NCAA Initial Eligibility Center (Clearinghouse)? (Y/N) ______
Intended College Major: _____________________________
Anticipated Start Date:__________
Other Colleges that you are applying to: ________________________________________
Parents/Guardians Names and Occupations: _____________________________________
____________________________________
Number of Siblings (ages): ___________________________________________________
Water Polo Specific Information:
HT. ____ WT. _____ Dominant Hand: _____Ambidextrous? (Y/N) ______
H.S. Water Polo Coach _____________________Phone # ________________________
Club Water Polo Coach _____________________Phone # ______________________
Positions Played: __________________________ How many years playing water polo?____________
Speed: 50 Freestyle Time (y/m): ____ 100 Freestyle Time (y/m):____
Swimming Specific Information:
Swim Year Round? (Y/N) ____ How many years? ______
SWIMMING TIMES:
FREE FLY BACK BREAST IM
50 XXXX
100
200
400 XXXX XXXX XXXX XXXX
500 XXXX XXXX XXXX XXXX
OTHER
Please Complete and Return to: Curt Altschul - Men’s & Women’s Swimming & Water Polo Coach
Salem International University
223 West Main Street
Salem, West Virginia 26426
304-326-1475
