Introduction Section
WELCOME TO THE AZUSA PACIFIC SWIMMING QUESTIONNAIRE!!!

Thank you for your interest in Azusa Pacific Swimming and Diving. In the meantime please continue with NCAA registration as well as your Azusa Pacific general application. Our coaching staff will evaluate your information at this time and we will be in contact if we are interested in pursuing you as a student athlete here. Thanks.
Questionnaire Code
(not required):
Personal Information
First Name:
Middle Name:
Last Name:
Preferred Name:
Country:
Address Type:
Street Address:
City:
State:
Zip:
Grad Year:
Date of Birth:
Email Address:
Home Phone:
Mobile Number:
FaceBook:
Twitter:
@
Instagram:
@
What is your connection to this university:
Parent(s) Information
Parent 1's First Name:
Parent 1's Last Name:
Parent 1's Gender:
Parent 1's Address (If Different):
Parent 2's First Name:
Parent 2's Last Name:
Parent 2's Gender:
Parent 2's Address (If Different):
Academic Information
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School Name:
School Address:
School City:
School State:
School Zip:
School Phone#:
GPA:
Intended Major:
Have you Joined the Eligibility Center?
Eligibility ID:
Club Information
Club Name:
Club Address:
Club City:
Club State:
Club Zip:
Club Coach:
Club Coach Cell:
Club Coach Email:
Events

Important: Once you select an event all fields for that event are required and must be input correctly. If all fields are not filled out correctly then those values will not be logged with your application.

Distance Type Best 1 Best 1 Date Best 2 Best 2 Date
Event 1
Event 2
Event 3
Event 4
Event 5
Event 6
Other Questions
Do you have any online video? If so please provide the link.:
When you have completed this questionnaire please click submit questionnaire.
School Name:
OR :
State:
City:


Club Name:
Team Name:
Coach Last Name:
State:
City:


Club Name:
Team Name:
Club State:
Club Coach First Name:
Club Coach Last Name:
Club Coach Email:
Club Coach Mobile:

Do you still want to add the prospect?