Undergraduate Admission Attending Drury: • Apply Now • Scholarships • Visit Campus • Request Information • Majors & Minors • Required Forms • YouTube Videos More Information: • Contact Your Counselor • Drury Unscripted Information For: • Freshmen • Transfer Students • International Students • Graduate, Adult, & Online Students Contact: Office of Admission Office: (417) 873-7205 Toll Free: 1 (800) 922-2274 Fax: (417) 866-3873 druryad@drury.edu

Athletic Questionnaire - Swimming and Diving Brian Reynolds, Head Coach Phone/Fax: 417-873-7293 E-mail: breynold@drury.edu Bryan Beatty, Asst. Coach Phone/Fax: 417-7422 E-mail: bbeatty@drury.edu Richard Hackett, Diving Coach Phone/Fax: 417-873-7422 E-mail: rhackett@drury.edu Last Name: First Name: Middle Name: Sex: Male Female Home Phone: Cell Phone: Address: City: State: Zip: SSN# Date of Birth: Email: Parent Name: Day Phone: Parent Name: Day Phone: Occupation(s) List any friends or relatives that have or are attending Drury. Academic Information High School or Junior College: Address: Phone: Graduation Year: Intended Major(s): GPA(4.0 scale): Class Rank: / ACT: Date Taken(mm/dd/yy): SAT: Date Taken(mm/dd/yy): TOEFL(Foreign students only): Date Taken(mm/dd/yy): Athletic Information Number of years Swimming/Diving: Club Team : Coach: Coach's Phone: Age: Height: Weight: List best times in 6 events - Divers record diving list and best scores on back. Event Time Date Honors and Recognition:

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