Office of Sports Information, Bloomsburg University of Pennsylvania

Bloomsburg University Swimming Recruiting Form

* Required Fields. Note: Social security number will be required by the NCAA clearing house; providing it now on our secure form will save time in processing your interest in BU.
Personal Information
Name*   NCAA Eligibility Center ID # *
Street Address*    City*    State*    Zip Code*
Home Phone   Birthdate (mm/dd/yy)
E-Mail Address
Father's Name:   Occupation:
Mother's Name:   Occupation:
Academic Information
High School   School Phone
High School Address:
Guidance Counselor:
SAT-Verbal    SAT-Math    SAT-Written    Date Taken
ACT Score(s)   Date Taken
Grade Pt. Avg.   Class Rank   Graduation Date
Curriculum Desired in College
Have applied to Bloomsburg University?  YES NO
Have you been accepted to Bloomsburg University?  YES NO
Athletic Information
Have you completed NCAA Initial-Eligibility Forms?  YES NO
High School Coach   Coach's Phone #
Club/YMCA Coach   Coach's Phone #
Events/Times
Event 1   Time: 
Event 2   Time: 
Event 3   Time: 
Event 4   Time: 
Event 5   Time: 
Why are you interested in and swimming for Bloomsburg?
If done, submit this form