Athlete Representative Nomination

Please fill out as much of this form as possible. Don't be modest because your peers will be voting for the athlete they think is best qualified.
Please note: Due to CSI Bylaw imposed limitations based on club affiliation, multiple athletes from the same club may be nominated however only one (1) athlete per club may serve on the Board of Directors.  If multiple athletes from the same club are on the ballot, the athlete with the most votes will be counted and subsequent athletes will not be counted.
By submitting this nomination, I agree that if elected I will remain a CT Swimming member for 2 consecutive years, reside in the CT Swimming area, and attend Board of Directors meetings.* Yes No
High School:
Number of years involved in swimming:
Scholastic Honors:
Member of High School Swim Team? Yes No
If yes, how many years:
Achievements you are most proud of during your competitive years:
Things you are most proud:
Extra Curricular Activities:
What do you think the role of Junior Athlete Representative should be?
Why will you be a good representative of the Connecticut swimmers?
Parents or Guardian Name:*
Street Address:*
Zip Code*
  (What is this for?)