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.

Name:*

Email:*

My current grade is:* Sophomore Junior Senior

Age:*

High School:

Competed within the 3 immediately preceding years, in the program of swimming conducted by CSI or another LSC:* Yes No

Club:*

Number of years involved in CT swimming:*

My Coach is aware and approves of my nomination for Jr Athlete Rep:* Yes No

Please note a short 3 minute or less video is required to accompany this application. Videos can be emailed to athletes@ctswim.org. Please address the following: Name, grade, high school, club Volunteer/Work experience Why you want to be the Junior Rep What are your ideas for the Athlete Committee

I agree to having my video posted on CT Swim social media:* Yes No

Prior to the election, I understand I am required to attend or watch the Athlete Rep Open House Zoom: * Yes No

The Open House will be via Zoom and can be attended in real-time. A recording will be available for those who cannot attend. Please check the CT Swim Instagram Account for details.

I agree that if elected I will remain a CT Swimming member for 2 consecutive years, reside in the CT Swimming area:* Yes No

I will make every effort to adhere to the Athlete Rep Responsibilities as details on the Athlete Rep page.* Yes No

Athlete Representative Page.

Parents or Guardian Name:*

Email:*

I agree to allow my athlete to run for Jr Athlete Representative:* Yes No

(What is this for?)