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Navy Men's Swimming Questionnaire

Date Completed:
Personal Information
Name:
Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Social Security Number:
Height:
Weight:
High School:
High School Address:
Email:
Birthdate:
Birthplace:
Father's Name:
Mother's Name:

Academic Information
Class Rank and Class Size:
PSAT Score V:	M: Date Taken:
SAT Score V:	M: Date Taken:
ACT Score V:	M: Date Taken:
Date of Graduation:

Upon graduation I will have completed:

Years of Math:
Years of English:
BIOLOGY (Yes or No):
TRIGONOMETRY(Yes or No):
PHYSICS(Yes or No):
CHEMISTRY(Yes or No):
Athletic Background
List Past Accomplishments (Events,Best Times, Swimming Honors, Team Captain):

High School Coach's Name:
High School Coach's Phone:
High School Coach's E-mail:
USS Coach's Name:
USS Coach's Phone Number:
USS Coach's E-mail:

Please list times and days that you train:

Sun.

Mon.

Tues.

Wed.

Thurs.

Fri.

Sat.

Names of Navy Midshipmen or Alumni that you know

By submitting this questionnaire you hereby authorize the release of your academic transcript to the U.S. Naval Academy. You will then be redirected to the Navy Athletics home page.
This questionnaire is for evaluation purposes by our coaching staff. It is not an application for admission to the Naval Academy. It you desire to become a candidate for admission we recommend that you complete the questionnaire for the admissions office at: www.usna.edu/Admissions/steps.htm

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