South Dakota Swimming Scholarship Application

Graduating Senior - 2007

1.  Please provide the following contact information:

First Name ________________________ MI __ Last Name ______________________________

Your Address ___________________________________________________________________

City, State, ZIP __________________________________________________________________

Home/Cell Phone _____________________ Email ______________________________________

Club Name ______________________________________________________________________

School ________________________________________________________  GPA ____________

2.   Please provide the following coach information:

First Name ________________________ MI __ Last Name _______________________________

Organization _____________________________________________________________________

Fax  ____________________  Phone __________________ Email _________________________

3.    Please provide the following information:   

High School ______________________________________________________________________

High School GPA: __________

4.    What activities are you involved in?

5.     What high school honors have you received?

6.     What swimming recognitions have you received?

7.     List two (2) personal references other than your parents.

Print and mail this personal data sheet along with the other scholarship application documents to the Scholarship Committee (Senior Vice Chairperson).

Applications must be postmarked no later than July 20, 2007.