Virginia Swimming and Diving Unofficial Home Page

Prospective Diving Student-Athlete Questionnaire
Please submit the following student athlete questionnaire by:

1. Sending an e-mail with the biographical information listed below to this e-mail address: uvadivingcoach@earthlink.net

2. Sending a fax with the biographical information listed below to 434-982-5271

3. Mailing the biographical information listed below to the following address:

Rich MacDonald, Diving Coach
Virginia Swimming & Diving
P.O. Box 400316
Charlottesville, VA 22904-4316

Personal Information

Name:

Date of Birth:

January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 ,

Eligibility Center ID Number :

Address:

City:

State:

Zip:

Phone Number:

E-mail:

Height:

Weight:

Parental Information

Parents' Name:

Parents' Occupation:

Name of College Parents Attended:

Academic Information

Graduation Year:

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Current Year in High School:

Senior Junior Sophomore Freshman

High School:

H.S. Guidance Counselor:

H.S. Phone Number:

Class Ranking:

SAT:

Math:

Critical Reading:

Writing:

SAT 2:

Verbal (Written):	Math: Please indicate: C1 C2
Please indicate subject (Biology, Chemistry, Physics, Spanish, French, etc.):	Subject Score:

ACT:

Please List AP Courses Completed or Currently Enrolled:

Academic Achievements:

Diving Information

YMCA, U.S. Diving Club:

YMCA, U.S. Diving Club Coach:

YMCA, U.S. Diving Club Coach Phone Number:

High School Coach:

1 Meter:

6 Dives:

11 Dives:

3 Meter:

6 Dives:

11 Dives: