Michigan Swimming On-line Record Application
This application will be emailed directly to JBCartmill@hughes.net, MS' Records Coordinator,
when you hit the submit button. Please complete every relevant field in this application.

Submitter's Information
Submitter's Name:   
Club Code:    Club Name:
E-Mail Address:         Phone Number:   
 
Record Information
Meet:  (Date)      (Host)      (City)      (State)     
Distance:      Stroke:      Course     Age Group 
Gender    Race Type:    Time (Mins:Secs.Hunds):    : .
Meet Type: USA Sanctioned Meet    USA Approved Meet    USA Observed Meet
Event Type: Regular   Time Trial   Swim Off   Lead Off Leg
 
Record Setter(s) Name (if this record is for a relay, list in order each member swam):
Swimmer/Leadoff:   (First)    (MI)    (Last)     (USA #) 
Relay - 2nd:   (First)    (MI)    (Last)     (USA #) 
Relay - 3rd:   (First)    (MI)    (Last)     (USA #) 
Relay - 4th:   (First)    (MI)    (Last)     (USA #)