Rider University - Dive Questionnaire

Fields marked with an asterisk (*) are mandatory

*Today's Date:
*Date of Birth:
*Your full name (first, last, M.I.):
*Home Address:
*City, State, Zip Code:
*Home Phone:
*E-mail Address:
*Gender	Male Female
*Height:
*Weight:
*High School:
*High School Address:
*Graduation Date:
*Mother's Name:
*Father's Name:
*High School Coach:
*High School Coach Phone #:
*Club Team:
*Club Coach:
*Club Team Coach's Phone #:
*Guidance Counselor:
*SATs:
*GPA:
*Class Rank/out of:
*Academic Interest in College:
*Other colleges considering:
*List Placement in Major Championships, Sectionals, States, etc.:
*Best 1 Meter Score:
*List all 1 Meter Dives (Front - Back - Twist - Reverse - Inward):
*Best 3 Meter Score:
*List all 3 Meter Dives (Front - Back - Twist - Reverse - Inward):

When you are satisfied, please click