Recruitment Form For Swimming

EVENT	TIME
SWIMMERS MEETING ONE OR MORE OF THESE TIME STANDARDS ARE ENCOURAGED TO SUBMIT A SWIMMER QUESTIONNAIRE.
50 FR	:26.99
100 FR	:58.19
200 FR	2:05.10
500 FR	5:31.80
1000 FR	11:23.90
1650 FR	18:58.69
100 BK	1:04.20
200 BK	2:17.90
100 BR	1:13.20
200 BR	2:38.00
100 FL	1:03.30
200 FL	2:18.19
200 I.M.	2:20.90
400 I.M.	4:59.30

First Name:
Middle Initial:
Last Name:

Address:

City:		State:
Zip:
Phone:		E-mail:
Birth Date:		Age:

High School:		Grad Date:
High School Address:

City:		State:
Zip:

Class Ranking:		Class Size:
GPA:		SAT:
NAT'L ACT:

Best events, times/scores in the last two years:(Short and Long Course) (Divers: 1M & 3M)

Name and Address & E-mail of Friend(s) we may recruit:

Have you registered online with the NCAA Clearing House? Yes No

On a scale (1= not interested, 10 = very) rate your interest in Mesa State Aquatics:

*Financial Aid & Scholarships are available. Please apply.

Head Coach: Brian Pearson (970) 248-1445 (W) (970)248-1980 (F) Email:bpearson@mesastate.edu

FOR MORE INFORMATION ON MSC WOMEN'S SWIMMING & DIVING
PLEASE CONTACT COACH PEARSON AT 970-248-1445

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