College of Arts and Sciences L&C PE/A Home Student-Athlete Interest Profile
 



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Swimming Student-Athlete Interest Profile

About You

First Name

Last Name

Preferred Name

Date of Birth (mm/dd/yy)

Height Weight

Male Female

Street Address
Street Address (line two if necessary)

City

State

ZIP

Home Phone

Cell Phone

E-mail Address
Do you intend on applying for financial aid?YES NO
What is your interested area(s) of study?

About Your School/ Academics

High School/JC

City

State

Class Rank of

Graduation Date

Grade Point Average

Standardized Test Scores (best scores to date)

SAT Verbal SAT Math SAT Written ACT

How many years of each of the following subjects did you/ will you complete in high school?
ENGLISH Four Required
MATH Four Required
SOCIAL STUDEIS/ HISTORY Three Req/ Four Prefer
LAB SCIENCE Three Required
FOREIGN LANGUAGE Two Required/ Three Preferred
FINE ARTS One Required

SWIMMING INFORMATION

High School Coach HS Coach's email
HS Coach's phone #
Club Team Club Coach
Club Coach's email Club Coach's phone #

Please input your best times:

50 FREE 100 FREE 200 FREE
400/500 FREE 800/1000 FREE
1500/1650 FREE FREE Relay Splits
100 FLY 200 FLY FLY Relay Splits
100 BREAST 200 BREAST BREAST Relay Splits
200 IM 400 IM IM Relay Splits
100 BACK 200 BACK

1. Goal Meets/Dates/ Locations for this season
2. Goal Meets/Dates/ Locations for this season
3. Goal Meets/Dates/ Locations for this season

Athletic Honors/Awards:

Present Training Schedule
Hours per Week
Weeks per Year

Swim Sessions per Week

Dryland Sessions per Week

ADDITIONAL INFORMATION ABOUT YOUR FAMILY

Father's Name

Father's Occupation

Father's College Attended

Mother's Name

Mother's Occupation

Mother's College Attended

Parent's Status MarriedDivorcedOther

I live with BothMotherFatherOther

Number of siblings
If any siblings in college, list schools attending If any siblings graduated college, list schools attended

Ethnic Background

MORE ABOUT YOU

What are your major considerations when choosing a college? (rank in order of importance)

Academic Match
Quality of Swim Program
Financial Aid Offered
Location of School
Getting along with team
Size of School
Parents
Other (please specify)

What qualities/programs does your ideal college have?
How well does L&C match your ideal college?
How does distance from home factor into your college decision?

How do you feel you would fit into the L&C campus environment?
List your top-five schools at this time (in order of preference)
Rate Your Interest in L&C (10 High, 1 Low)
Have you received an application from Lewis & Clark College YES NO
Have you visited Lewis & Clark College YES NO
If no, when would you like to plan a visit?
Questions for the Coach?

Submit Info

Additional comments: